graphic memoir Letter Writing Life writing Our Projects

Letters to… Arts&health workshops and research

Join in celebrating and reinventing the hand-written letter. Relish the imperfections. Physical letters inform us in so many ways: they are about the trail we leave and the future we wish to shape.
If you’d like to book a letter making event or workshop, email us on
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Letter to my Breath: 

As part of the award-winning team at Life of Breath Project (2018 Health Humanities Award), we’ve run over 10 “Letter to my breath” workshops along with Dr Alice Malpass, and organised Being Human Festival event Gasp! Exploring Breath Through Creative Arts at The Arnolfini, other community events such as Breath letters at Fun Palaces. Our related papers and talks are outlined below. 

Penny, E., & Malpass, A. (2019). Dear Breath: using story structure to understand the value of letter writing for those living with breathlessness–a qualitative study. Arts & health, 1-15.

Malpass, A., & Penny, E. (2019). Invisible Breath. Storytelling, Self, Society, 15(1), 43-70.

February 2020: we showed letters to the breath to a big crowd at the end exhibition of Life of Breath Project at Bristol Museum and Art Gallery. Dr Alice Malpass gave a talk including the research we’ve done using the letters, and what we’ll be doing next. It’s exciting to see where the legacy of our work will go now that Life of Breath is over.

Rap to the Breath by Mandeep Singh and friends.

We love this rap – what can I say about it except… big breath in… it’s inspired. It was written and recorded by Mandeep Singh, a year 6 medical student in Jamaica, after he ran a workshop in Southmead for us, for the Catch Your Breath workshop programme. The ideas about breath in the rap bubbled out of all present in the workshop, so credit and respect to all participants.

Thank you to Dr Heather Yoeli, Northumbria University for writing to us about how our work has helped her work:

How did your Letters to Breath project influence me? Well, essentially, I came to my role with the Life of Breath as a prose writer as well as a researcher. Your work provided me with an example of how ethnography and the medical humanities give real credibility to the process and structure as well as to the content of the literature which people living with chronic illness produce. As a result of reading your publications, I was inspired to pursue my tentative dream to encourage the Singing for Lung Health group with which I was working to write their own song, and to use this song as the basis of the study.

Letters for film makers, amongst exotic potions.

I’m part of a gorgeous group of women film makers who meet regularly in Bristol, and when it was my turn to offer a workshop, I ran a letter making workshop for them. Unexpectedly, we couldn’t get into our usual venue so I ended up running it from behind the wooden counter at the narrow and wonderful herbalist ‘Urban Fridge’ in Colston Street – all brown bottles and exotic potions. I felt strangely at home as an ersatz herbalist (with my feathers, inks and a mini selection of materials laid out in front of me) and if I was 25 years younger would certainly be asking for a Saturday job there. I made do with buying some orange peel digestive bitters from Max the owner.

Exhibition at Southmead hospital

Great to see Alice, Louise and my work on Letters to the Breath represented in the Catch Your Breath exhibition at Southmead hospital. Louise Jenkins’ work Breath Capsules, using letters that our participants have made, looks stunning. Anyone can go and see the exhibition – walk inside the main entrance, down the foyer in Southmead hospital, it’s nearly at the end on the left. #breath #artsandhealth #catchyourbreath. The exhibition will move to Bristol Central Library in January 2020.

Here’s a January 2020 blog post about two of my recent workshops:

Letter to My Superhero 

Lovely development for my letter writing project. I’m part of “Community Connections”, a social prescribing programme in the South Ward area of Weston-super-Mare. A full-time social prescriber is taking referrals from health professionals working in the For All Healthy Living Centre, who will connect people to non-medical support within their local communities and beyond. Cooked up by the lovely Fiona Matthews Theatre Orchard, and with Arts and Health South West support, the programme has a particular focus on working with and through creative and arts-based approaches. I’m running a series of workshops over two years to help towards the evaluation programme. This involves me leading a workshop called Letter to My Superhero, as well as working alongside K Scottish comedian and comic strip creator, Kev Sutherland, Scottish comedian and comic strip creator (including for the Beano and Marvel).

Life of Breath Project Paper/Presentations

Paper: 2019 Malpass A. Penny, E. Invisible Poem: writing letters to the breath self and creating visual stories: Storytelling, Self and Society

2019 June.  Workshop at The Storytelling For Health conference in Swansea along with GP Dr Gene Feder and Dr Alice Malpass.

One of 4 exhibition art works at the Storytelling For Health Conference is a piece inspired by our Letter to The Breath Project, by artist Louise Jenkins.

2019 Provocation at Culture, Health and Wellbeing Alliance: Cultures of breathlessness: using creative letters to the breath to navigate narrative wreckage.

Paper: 2018 Penny, E. Malpass, A Dear Breath: using story structure to understand the value of letter writing for those living with breathlessness – a qualitative study: Arts & Health: Vol 0, No 0

Blog posts:,,

Looking towards Spring 2019

Excited to be running 3 pilot workshops in primary schools, funded by Life of Breath Project. The workshops will involve creative letter writing, puppetry and dance.

Also, Dr Alice Malpass and Elspeth are delighted to announce that our first paper “Dear Breath: using story structure to understand the value of letter writing for those living with breathlessness – a qualitative study”, has been accepted for publication with Arts & Health journal and we’re looking forward to presenting workshops and more at the letters at the Life of Breath final exhibition Catch Your Breath in Bristol in 2019 (currently on display in Palace Green Library, Durham).

Winter 2018

Two blog posts in 2018 on my Letter to the Breath project with Life of Breath Project, University of Bristol:

And a blog post on Art, mother and son, nature and transition….…/…/arts-residency-at-the-mothership

Emotion Coaching Autumn 2017

Writing a letter to your breath 2017

November 24th: Being Human Festival. An afternoon of activities about the breath. Our breath in our hands…. great to see this new Life of Breath project blog post: Dr Alice Malpass writes about the @BeingHumanFest event “Gasp!” with Elspeth Penny exploring how an installation artist, puppeteer, musician, writer, dancer & choreographer use breath/breathlessness in their work. .

Burnley: Thanks to Janet Janet Swan: Reading. Story. Voice at the wonderful Burnley Singing For Lung Health Group. Dr Alice Malpass and I loved running a workshop there in November for our research project. Fifteen singers wrote letters to their breath, as well as started Christmas tree decoration letters.

September 2017: Super generous contributions to my Festival breakfast talk…/festival-breakf…  at The Bristol Festival of Puppetry on 7th September, and a great turn out.

My notebook is now full of observations and ideas for a play which is emerging… Co-hosted with puppeteer Chris Pirie, we explored puppets, breath, performance possibilities, croissants, grapes and coffee in the Tobacco Factory foyer. At the table were cast and director from The Broke ‘N’ Beat Collective who were fresh from a victorious show the night before. Also Dr Alice Malpass from Life of Breath, musician Paul Bradley, my yoga teacher sister Diana, and a 90 year old local lady who turned up half way through with some puppets and told us some funny stories. Thanks to Emma and Lucy from Puppet Place for organisation and helping Puppet Place.

Meeting my on screen ‘husband’ story-teller Stuart Packer for the first time, just before the launch of the David Mackie short film Breakdown that we were both in

July 2017: Some fantastic feedback and follow up opportunities after our conferences this summer for Dr Alice Malpass and I: we spoke in Swansea and Bristol about our innovative arts and health work using the letter writing workshops. Looking forward to developing our ideas some more.

Letter to Your Breath: podcast by Dr Sarah McLusky Project Manager, Life of Breath

Dr Alice Malpass and myself presented at Swansea’s Storytelling for Health Conference, Saturday 17th 2017 June, 11-13.00 Reading Room, School of Architectural Glass, Alex Building. Title of session… Creative Writing Workshop. We’ll be looking at narrative in our project Letter to my Breath, and some of it will be practical. We’re presenting alongside two other creative writing workshops – Sarah Goodey from Healing Words and Vicky Field from The Poetry Practice… exciting!

Culture, Health and Wellbeing International Conference
19,20,21 June 2017 Bristol UK….Dr Alice Malpass and I talked about our work together for the Life of Breath Project, including Writing a Letter to my Breath on the day for Policy, acute care, medical humanities, arts therapies.

MAY 25 2017 Bath Spa Uni,Thank you to Dr Pamela Karantonis
Senior Lecturer in Acting (Voice)
Newton Park Campus, Bath Spa Uni, for facilitating and hosting a Letter to the Breath workshop yesterday, with Creative Corporealities group (and for the delicious coffee). It was a balmy day, but everyone was very productive. Dr Alice Malpass and I so enjoyed working with your group, and some smashing letters were created. I hope some further collaboration will come out of it.

Newsletter extract written by Rachel Lowrie, English Teacher, for Churchill Academy in the February 2017 newsletter:

On Wednesday, we were lucky enough to welcome Elspeth Penny and Dr Alice Malpass from the Life of Breath Project into school to run a workshop for 12 students. During the session, students learnt to become more aware of their breathing and to be thankful for its help in allowing us to live, laugh and sing. Following a series of warm up activities, including consideration of the lost art of letter writing, the students culminated the process by creating a note to their breath. Some employed a quill to record their thoughts, others painted their ideas with homemade beetroot ink and sprayed their paper with the scent of rose or pine. There was not a biro in sight! Using the abundance of tools and resources that were on offer, their masterpieces both touched and inspired the group.

Dr Alice Malpass and I ran a workshop in Burnley in November 2017 – what a big pleasure! It was for Burnley’s British Lung Foundation Singing For Lung Health group.
We now have some more fantastic Letters to The Breath for our research @lifeofbreath, Bristol University…/burnley-singing-for-lung-health. 

I am including a wonderful email I received, after the session – thanks so much Janet.

Hello Elspeth and Alice,
I met the group again yesterday and got some more feedback. I also have had time to reflect on the session so here goes!
Comments from members written into the leader’s comment book:
A different and interesting way of looking at one’s breath.
An enlightening way to understand better how I breathe.
Enjoyed the day – thank you
It was good to hear that other people have the same problems as me. If we did it more often we could share more positive thoughts and plans.
A very interesting experience. Thank you.
Comments from members heard in discussion:
Yes it was good especially hearing each other’s stories.
Why just one day? We need more.
We could have spent a whole afternoon on it.
Comments sent to my by email / text:
 There were some very moving comments made at the workshop
It was a lovely experience.
G has been too moved to tell me anything about the art set (from M).
My thoughts / reflections:
I will write up about the benefit of doing this sort of activity for the other SfLH group leaders around the country. In particular how much it benefited the group dynamics:
I was impressed at how much gravity everyone gave to it. Not that it wasn’t fun – but just that everyone really got into the flow of the activity and gave it their serious consideration.
Everyone got chance to produce something and got positive feedback including claps from the group. Some people who are very quiet in the group had their chance to shine and share as an individual. This may therefore have a knock on effect for group identity and group management – as people learned things about other members that they didn’t know before. Certainly in the first meeting afterwards there were more members chatting before and after the group with some people helpfully arriving a little earlier instead of at the moment that the group starts.
There was some very honest sharing about people’s illnesses and how they feel about it. This will certainly help people to support each other more – and indeed the conversation yesterday did relate more to people asking each other how they were in a very genuine way.
It was interesting to see people in a different setting. I particularly liked how husband and wife (A and P) interacted: A supported P and gave her lots of positive comments about her letter. I was impressed at how much G shared about his illness – he is usually very jokey and flippant and I realise that this is all a bit of a show when actually it impacts on him much more than he lets on.
It clarified relationships because we all took part. T (volunteer) was able to show that he too has breathing difficulties, M was able to point out that although she comes as G’s carer, she too is gaining so much from the group and it is helping her deal with her cancer, I was able to share about my Mum.
There did feel to me to be a bit of a pressure of time, but I don’t think the group felt under pressure. There were just 2 comments about wanting more time (included above).
We are going to do another half hour or so after next week’s class in order for people to finish off their Christmas tree creations and add them to the tree that will be put in the church for the Christmas tree festival.
I think that is all for now.
All best wishes and thank you again so much. It has added so much to the group.
Best wishes,

Spring 2016…. lovely feedback from a workshop:

‘Your workshop last Tuesday gave our Breathe Easy members food for thought and a creative outlet not experienced often enough on third Tuesdays in the Acorn Suite. I hope you agree that the varied response, in words and images, is proof of the value of the afternoon to those present, not least the fun of it.
Mary tells me that the procession of the exercises led her to realise she could rise above negativity and begin again to enjoy life.’ Mike Green, chair of the Forest of Dean Breath Easy group.

Elspeth is excited to have been asked by Dr Alice Malpass of Bristol University to work on a research study about our relationship with the breath. It’s part of a larger project called Life of Breath, funded by the Welcome Trust. Elspeth will be running ‘Writing a letter to my breath’ workshops.

Healthy City Week 2016

Elspeth ran several workshops:

1. Letter to my Bones (or other body parts!)

Saturday 15th Oct at 1.30 at Wellspring, Barton Hill:

Elspeth Penny, with her letter-writing rack, unusual pens, inks and inspiration invites you to write, create or draw a hand-written letter to your own bones (or another body part such as liver, brain, lungs, heart). No one will be correcting your spelling or grammar here, but hopefully you’ll see your health in a new light and remember how enjoyable it is to write a letter. Everyone welcome.”

This was part of…

2. A Letter to my Pain & Duet of One, a collaboration with Raquel Meseguer.

Friday 21st October at 5-7pm at Hours Space, 10 Colston Yard Bristol BS1 5BD


A free two-part workshop, for those with an invisible disability or long-term pain condition: this is your space. It is the chance for you to invite someone you know (a friend, partner, sibling) to experience a two-part workshop with you.
In A Letter to my Pain, Elspeth, with her letter-writing rack, unusual pens, inks and inspiration will guide you to write, create or draw a letter to your pain, or to your body (placing the person in pain first).
In Duet for one, Raquel will then invite you and your plus ones to slow down, listen closely, and find a truly healthy groove.
n.b. This event aims to raise awareness of invisible disability, and welcomes anyone with a disability.
For ticket: click here
For more info please contact Elspeth:
Find out more about Healthy City Week at

Elspeth took 34 children caving at Goatchurch Cavern in the Mendips, followed by a poetry workshop (see the stalactite words hanging in the classroom as the poems begin to form): funding from Discovering Blackdown Project. The poems went into the time capsule Elspeth arranged to go in Blagdon school attic, along with letters that the children have written to the future and to themselves in the future.

Our Time Capsule in Blagdon
Blagdon Time Capsule: Mendip Times article January 2016

If you’d like to book a workshop: email us on

Workshops and training

Communications Training in Medical Education

Lunchtime at The SAS conference, Plymouth, 2016.. Smeaton's Tower on the Hoe.
Lunchtime at The SAS conference, Plymouth’s Hoe, June 2016. Smeaton’s Tower, an Eddystone Lighthouse.



We get great feedback from talks and workshops we present, at conferences and universities:

‘Thank you so very much for your participation, which made a huge difference to the event and helped make it a success.’ Dr Imran Saif. MB BS, FCPS (Med), FCPS (Neph), FASN, FRCP. Associate Postgraduate Dean, Health Education England. May 2016

We’ve had several summers of successful workshops and public talks, and we now are pleased to offer training with a bit of oomph, for healthcare professionals. With the threat of high litigation bills and Duty of Candour, it’s essential to learn how to maximise communication skills.

Sessions are interactive and participatory, led with sensitivity, panache and humour by Communications Specialist and actor Elspeth Penny and medics including Oncology Professor David Radstone and consultant Dr Mike Jeffreys.

We have presented on the topics:

  • Challenging Conversations (SAS Doctors’ Conference, Plymouth 2016).
  • How To Communicate Bad News Well (The 4th Annual SAS Doctors’ Conference in Bristol 2015, The Patient Safety Conference 2015).
  • Consulting students, facilitating medical consultation skills sessions and providing simulated patient services for ten years for medical students at Peninsula Medical School, Plymouth University, Bristol and Bath University.

About our workshops:

More Feedback on our workshops:

  • ‘Dear Elspeth,

My team and I would like to thank you and Dr Mike Jeffreys for presenting at our 5th Annual SAS Doctors’ Conference at Plymouth on 10-11 May 2016.

The conference went extremely well and informal feedback I received from the delegates was excellent; we will send you the formal feedback next month.

Thank you so very much for your participation, which made a huge difference to the event and helped make it a success.’

Dr Imran Saif. MB BS, FCPS (Med), FCPS (Neph), FASN, FRCP. Associate Postgraduate Dean, Health Education England.

  • ‘The feedback has been very positive and we would like to thank you for your contribution’, Faculty and Trainee Performance Administrator at Health Education South West. Professor David Radstone and Ms Elspeth Penny – How to communicate bad news to patients 2
  • ‘Dear Elspeth, thank you so much for doing the Breaking bad news talk at the conference with Professor Radstone. It was good to have a talk that made people reflect on what it might feel like to be the patient or the patient’s relative. The scene where Professor Radstone broke the bad news to you made many people feel quite emotional, me included’. Katherine Dougherty, Conference Director.
  • ‘Thank you for your professionalism, excellent role-play and feedback,’ Dr Andrew Tressider, Musgrove Park.
  • ‘Your comments and feedback really was spot on and very useful,’ Exeter University 2nd year medical student.
  • ‘I became familiar with Elspeth’s performance work through having observed her acting as a patient during a selection process for GP training. I was impressed by her authentic portrayal of the case concerned, as well as the flexibility she showed in responding to different interpretations by the trainee doctors, whilst staying within the confines of the brief – not an easy task. It is immediately apparent that Elspeth is a highly reflective practitioner who can adapt her performance skills to a variety of genres and for different audiences and purposes.’ Jane Rowe, Senior Fellow HEA, Learning and Teaching Advisor at Exeter University.


SAS conference programme

Arts and Health medical humanities Our Projects

Bring Research to Life

Writing and performing fictional scripts, based on research, helps take ideas and complex concepts to a public audience.

News off the press for March 2020… our play ‘Out Like Fudge’ will be translated and performed in Denmark in November 2020.

Out Like Fudge is a short play/vignette, which was shown at a nephrology (kidney) conference at Bristol Wills building last December. In the audience was Jeanette Finderup, Klinisk Sygeplejespecialist & Ph.d. Jeanette liked it and is having it translated for her conference.

Described as ‘Hard hitting’, by another conference attendee, ‘Out Like Fudge’ is one of two short plays Elspeth wrote for clinician and Phd candidate Barny Hole in Autumn 2019, based on kidney patients. Much of it is verbatim, as it’s based on spoken interviews that Barny recorded and transcribed, as part of his PhD. The story features Fudge, a pet who died quite suddenly: our character Jo would like to leave the earth in a similar way.

The play will be on the 6th November in the afternoon – Barny and Elspeth hope to be there to introduce it. The play will be called: Ikke mere udenomsnak.

Conference organiser Jeanette Finderup says: “We were not able to make a direct translation, but the Danish title indicate, that now we do not talk around the subject anymore.”

If Covid-19 travel permissions and clinical work commitments allow for it, Elspeth will do a short introduction of the play and Barny will present a lecture for one hour with the title: Hvad må det koste at leve længere for en patient i dialyse? “The title says something like: How much will a patient in dialysis pay to live longer?”

Rehearsing Out Life Fudge in the Wills Building, Bristol: Chris, Jo and Bede.

The project started when Clinician Barny Hole of Bristol University had a hunch that drama might be a good approach to help with public engagement around his PhD subject. Elspeth was recommended to Barny on the grapevine, and asked her to write and direct the work. In the early meetings, we agreed that humour was important, even through the humour might be dark. Also we wanted to stay true to the people in the interviews, whilst protecting their identities and fictionalising elements to make it into an easier story to follow.

We’ve performed it on two occasions, enabling both a PPI group, then clinicians and conference delegates at #dialysisbalance to reflect, and consider dilemmas about medical procedures from the point of view of a patient. Thanks to Jo, Karen, @ChrisPirie and Bede for their sensitive script-reading skills #dialysisbalance #bringresearchtolife #elizabethbackwellinstitute funded.

Feedback after December dialysis conference:

“I thought it was very well done, and I liked that the actors spoke the words from interviews – it was a clever idea”

“The words were impactful and very sad”

“I do like different ways of communicating messages this certainly got across some key points form real life experiences”

“The revelation that all the words came from real people facing ESKD decisions was powerful”

“very involved. Has left a significant mark on me as to how many patients must feel when they are told dialysis is required”

“So powerful”

“Slightly shocked by some of the language – it is hard-hitting but a really good way of getting insight through drama”

“I’m a GP… it was thought provoking, challenging of traditional approaches both in care but also conference content. I really valued that”