The therapeutic and health-promoting effects of writing have been explored by a number of researchers (see, for example, Pennebaker, 1997; Lepore and Smyth, 2002; Bolton, 2008), but the particular means whereby writing exerts its effects on health remain unclear. This chapter addresses facilitated creative writing as a rehabilitation measure with particular focus on the working mechanisms governing the effects of writing. The results are based on the research project Kreative skriveværksteder for mennesker med kroniske lidelser [Writing Workshops for InterventionsPeople with Chronic Illness], which was part of the Human Health (2018) focus area financed by the University of Southern Denmark, but they also include results from previous research projects looking at writing workshops for people with chronic illness (Hellum, Jensen and Nielsen, 2017; Zwisler et al., 2017; Hansen et al., 2019; Tarp et al., 2019). The chapter presents a model of the writing work-shops, describing the workshops’ form and content and some of the features that can promote or prevent a positive outcome from the creative writing. We suggest that the model might be relevant in relation to rehabilitation, health promotion, palliative care, and treatment.

Migration: An Overview

More than 250 million people around the world live outside their country of origin, signifying a 49 percent increase in global migration since the start of the twenty-first century (Khullar and Chokshi 2019). As an umbrella term, the International Organization for Migration (IOM) of the United Nations describes migration as the act of moving away from one's usual place of residence, whether within a country or across international borders, temporarily or permanently, and for a variety of reasons (International Organization for Migration [IOM] n.d.). These reasons range from the voluntary pursuit of seasonal or long-term employment opportunities to involuntary relocations for safety and asylum. More specifically, individuals who move and resettle temporarily are classified as “migrants,” while those who resettle permanently in a new country are classified as “immigrants” (International Rescue Committee 2022). Throughout this chapter, the term “(im)migrants” is used when describing all individuals who migrate for any reason, over any distance and at any time or frequency.

The United States is home to approximately one-fifth of the world's (im)migrant population, accounting for 46.6 million individuals (Budiman 2020). Based on Pew Research Center data adjusted for undercount from US Census data, most (im)migrants in the United States have legal status: 45 percent or 20.7 million are naturalized citizens and 27 percent or 12.3 million are lawful permanent residents. Another quarter (23% or 10.5 million) are residents with unauthorized status (Budiman 2020). The United States has also accommodated more than three million refugees since Congress passed the Refugee Act of 1980, which established the current refugee program and sets standards for screening and admission (Connor et al. 2017; Khullar and Chokshi 2019). Despite their prominent presence in the United States, foreign-born residents are a minority population, constituting 14 percent of the United States population. For refugees in particular, the United Nations estimated that nearly one million refugees resided in the United States in 2019: approximately 0.2 percent of the country's population (United Nations Department of Economic and Social Affairs 2019).

Reasons for migration can be subdivided into macro-elements (independent of the individual), meso-elements (related to the individual but not under their control) and micro-elements (related to an individual's personal characteristics and attitudes) (Castelli 2018).

Wars, crime and famine, among other circumstances, have driven millions to leave home and seek shelter among strangers. The situation worsens daily. This chapter examines strategies for restoring enduring empathy and an accompanying willingness to extend human rights across borders. It seeks to explain why giving sanctuary (a place of refuge and safety) is a human imperative. In seeking and offering sanctuary, we manifest, acknowledge and strengthen our sense of shared humanity and affirm life as a value. Providing and seeking refuge, furthermore, entail the recognition that human rights extend beyond the narrow scope of national boundaries. As such, sanctuary relies on a degree of empathy that reaches beyond perceived “in groups” to include all human beings. Conversely, the denial of sanctuary dehumanizes refugees and transforms an enriching resource into a threat to prosperity. That is not accidental. Where we dehumanize, we eradicate empathy. Where we fear, we strike to destroy. Is it possible, then, to have human rights for those among us forced to emigrate as refugees? Have human rights become through alienating practices only citizen rights? Outside the law of a given land, what protects and supports life? To address these questions, this chapter will discuss two myths and two affirmations that express powerful reasons to proffer refuge and extend empathy, not only toward human beings but also toward all living beings and toward the earth.

Two Myths

In Western civilization, two myths of shared origins have sought to explain and awaken among human beings a sense of kinship and community: Plato's audacious invention characterized by Socrates as a noble lie (Republic, 414b–e) and the creation stories in Genesis, 1:26-27; 2:7-8 and 2:19-25. Consider the latter first. In Genesis (1:26-27) the god creates all living things, the human to the god's image and likeness. As kin sharing a divine origin, all life commands respect and appreciation. The story, however, gives to the human dominion over the others. With dominion came hierarchical distinctions that dispelled from human emotion most fellow feeling toward other life forms. Once privilege-based dichotomies enter reasoning, alterity is deemed harmful to filial relations among living beings. The importance of biodiversity for providing stability and enriching the environment becomes blurred in anthropocentric policies that ignore extinction and endanger the variability of species. Failure to relate to living things, to experience oikeiôsis among living organisms, fractures relations among humans.

Vulnerable reading works on the opposite side of the street from narrative medi-cine: the side of the street where ill people live. But not only ill people. Vulner-able reading is for all those who are willing to acknowledge that they are strugg-ling to hold on to their sense of self and purpose, and even their desire to live. Some of these people are healthcare workers. Most will be ill people or people who are not immediately sick but whose chronic conditions or disabilities make them vulnerable. Vulnerable reading is about what these people might look for when they read to help them in their different struggles.

Unlike the usage common to narrative medicine, I do not—emphatically not—speak of patients as those who need vulnerable reading. Ill people become patients only during those times when they are being attended by a healthcare Interventionsworker. Vulnerable reading can help people reflect on what happens during those times of medical attendance, but ill people have an extensive life outside of whatever time they spend being patients, just as healthcare workers have lives outside that work. Vulnerable reading seeks to enrich those extensive lives (Frank, 2019).Narrative medicine's core mandate and focus has been teaching student clini-cians—at first medical students and now multiple health professions (Bleakley, 2015; Charon, 2017; Frank, 2017).

As demonstrated above, there is a long Gothic tradition in Swedish literature and film. It goes back to the Romantic period and the early nineteenth century when the first phase of imported English and German stories inspired Swedish writers to modify and adapt Gothic conventions to their local audiences. From the beginning, Swedish Gothic were place-focused stories, in which the Nordic landscape takes the role of a labyrinthine Gothic castle as a space of fear and terror. At the same time, the Swedish version of Gothic was densely intertextual with explicit references to well-known and iconic works produced outside Scandinavia. Thereby, Swedish writers placed themselves in a tradition of transnational Gothic, at the same time as they took for granted that their audiences were genre-aware and recognised references to iconic works. The first Swedish vampire story, Viktor Rydberg's The Vampire (1848), is an extended and elaborated response to Polidori's story from 1819, while Aurora Ljungstedt's The House of the Devil (1853) is a Gothic novel in the style of Ann Radcliffe and with explicit references to Radcliffe's novels.

Also, today's Swedish writers and filmmakers place themselves in a global Gothic tradition of canonised novels and films. The impact of international blockbusters, such as Blair Witch Project, has resulted in a domesticated Scandinavian version of mockumentaries with distinct Nordic features. The films are often structured as a journey from the ordinary urban everyday world into a mythological world lurking outside or beyond modern society. Here the force of nature acts as an external monstrous antagonist, such as in The Unknown (2000), directed by Michael Hjorth. In addition, a certain kind of Swedish blend of Gothic and realist narration has gained widespread international acclaim. One of the earliest and most successful examples is John Ajvide Lindqvist's bestselling vampire novel Let the Right One In (2007). It is set in a recognisable and explicitly named suburb outside the Swedish capital Stockholm, and it combines social realism with supernatural elements to address topical social problems. It was immediately translated into English and about 20 other languages. Lindqvist was also asked to write the screenplay to Tomas Alfredson's Swedish film adaptation from 2008, while Matt Reeves American remake, Let Me In, was released in 2010.

The most striking feature of Swedish Gothic since the early nineteenth century is the central part played by the Nordic landscape and mythological creatures of nature known from Nordic myths and popular belief.

Art, culture, and health

The links between art, culture, and health make up a growing interdisciplinary area of research that has gained international traction over recent decades. In a review of the documentation of the significance of art and culture for health and well-being in 2019, the World Health Organization (WHO) has singled out art and culture as important resources that can be integrated into various forms of health initiatives (Fancourt and Finn, 2019). Their review was based on a sur-vey of 900 publications, 200 of which were themselves reviews of 3,000 individ-ual studies. This makes it the most comprehensive pool of knowledge that has so far been made on the significance of art and culture in relation to health. It provides documentation for the ability of art and culture to support health services by, for example, promoting well-being and combating social inequality, reaching out to groups that are otherwise difficult to make contact with, and training health professionals in empathy and dialogue (ibid.).

Another smaller Danish review, surveying the literature on the value of art and culture in health initiatives, establishes that participating in artistic, cul-tural, or creative activities can promote mental health (Jensen, 2017). The effects emphasized in relation to such initiatives are increased quality of life, improved well-being and bodily understanding, as well as reduction of negative feelings and anxiety among participants. WHO also indicates the positive effects of these types of initiatives on a range of specific mental health targets and, in particular, underscores life satisfaction, a sense of meaningfulness, self-assessed health and cognitive abilities (Fancourt and Finn, 2019).

While WHO has emphasized the advantages of integrating art and culture in health initiatives from a general standpoint, several specific research projects on the topic are continuously emerging.

The ideological SS universe helps us better understand the actions of the SS men, including the way they rationalized their war crimes and atrocities – a theme we will return to in a later chapter on Waffen-SS atrocities. The question of how ideology influenced and shaped practice at the front is, however, broader and even more complex as we shall see in the following.

Racial Differentiation at the Front

Moving eastwards, the soldiers of the Third Reich faced various ethnic groups which caused countless ideologically motivated reactions among the Waffen-SS men. In October 1941, for example, a Norwegian soldier in the Wiking division informed in a letter that he had lately been guarding POWs, most of whom were Ukrainians. Among these, he found that there was “much strangeness to behold” and continued:

A report from the second SS Cavalry Regiment August 1941 on the massacre in the Pripet Marshes also made a point of distinguishing different groups from each other. Here, the Ukrainians made a relatively good impression: ‘although they were small, they all were of a harmonious figure and build and had a clear look’. As was the case in the Pripet Marshes, such race evaluations could have drastic consequences for the locals. An order from Himmler's personal command staff stated that areas populated by völkisch Germans or Ukrainians, where they did not like the Poles and the Russians, were to be protected. Conversely, where the population was friendly towards the Poles or were ‘racially and humanly inferior’ everyone under suspicion of supporting partisans should be shot and their villages torched. Thus, in this and similar cases a racial distinction was made between the so-called sub-humans and those who might not be Volksdeutsche or Germanic, but were deemed racially acceptable to a degree where their lives were preserved.

Naturally, racial differentiation also applied to the SS internally. In the summer of 1943, for instance, general Steiner instructed his armoured corps to place emphasis on racial and physical appearance when selecting officer material.

Teresa de Ávila lived in tumultuous times. Lutheranism was tearing Christian Europe apart. In France and in the Spanish territories to the North, Catholics and Protestants were at war. In the Americas, Spanish soldiers were facing untold dangers advancing the interests of the Crown, and one by one, Teresa's seven brothers joined their ranks. In Spain, the Inquisition persecuted those suspected of heterodoxy or spurious raptures, especially women. As an ecstatic and the daughter and granddaughter of conversos (converts from Judaism), Teresa was constantly under suspicion. Furthermore, opposition from the Carmelite hierarchy to the new religious order she founded, the Discalced Carmelites, put her squarely on the defensive. And during the last years of her life, the catarro universal—a global pandemic that, like Covid-19, spread like wildfire—claimed the lives of several of her close friends. In the midst of often harrowing circumstances, Teresa (known in the Spanish-speaking world as Santa Teresa de Jesús) sought refuge in her own soul—her “interior castle”—where she found spiritual peace.

Long before Teresa was born, many in Europe recognized the need for religious reform. By the late middle ages, the Church had become highly bureaucratic and materialistic, and religious practice was often reduced to a series of empty rituals. Parents frequently placed some of their daughters in female convents at an early age, often as young as 3 or 4, to avoid paying a marriage dowry, and some of their sons in male convents because, due to primogeniture, they were ineligible to inherit property. Consequently, these institutions were often overcrowded and inhabited by men and women with no real religious vocation. To counteract this situation, during the twelfth and thirteenth centuries, new orders were formed that stressed prayer over ritual and sought to foster an authentic relationship with God among their members. Some of the mendicant orders (those that forbid personal property) split into “conventuals,” who maintained a “mitigated” or more relaxed lifestyle, and “observants,” who adopted an “unmitigated” regime designed to promote genuine piety.

However, the spiritual reform was not limited to the religious orders. In the Low Countries, a new movement called the devotio moderna was gaining momentum among the laity as well as the reformed clergy. The devotio moderna was launched around 1374 by Geert Groote (1340–1384), a Dutch Roman Catholic deacon who believed that religious practices had become corrupted and void of meaning.