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15 Mar

Bibliotherapy: The Power of Books

bibliotherapyWe all had our favorite stories as kids – those books we begged our parents to read to us a million times over. As adults now, time might be tight, but delving into a really good book offers the same fulfillment and retreat. Our captivation with stories is, of course, as natural and inborn as our desire for music, our appreciation of art, our enjoyment of play. Little wonder, given they contributed so profoundly to social construction and cohesion for millennia. First, within a rich oral tradition, stories were passed down with great care and even ceremony to impart survival lessons and epic tales that circumscribed a tribe’s history and social mores. Narratives later became integral in spreading and binding together larger civilizations for the sake of formal religion and cultural identification. Stories, throughout human existence, have also been a conduit for the ageless, the universal, and the transcendental. Today, in a professional field dubbed bibliotherapy, mental health experts and educators explore how our natural affinity for stories can support our general well-being and even provide a healing influence for illness and trauma.

The field of bibliotherapy obliges the guidance of professionals, which commonly include trained librarians/teachers, social workers, psychologists or health practitioners. The “developmental level” of bibliotherapy, according to experts at the American Counseling Association, incorporates “[t]he use of literature and facilitative processes by skilled helpers to assist individuals in dealing with life transitions and normal developmental issues.” Clinical applications, on the other hand, involve “skilled mental health or medical practitioners” who utilize literature “in meeting specific therapeutic goals for the purpose of assisting individuals in dealing with severe disorders and traumatic life experiences.” In either case, the given professional assigns or recommends particular texts and refers to or discusses them within the learning, medical, or counseling relationship. (Bibliotherapy also includes writing therapy – more on that next week.) Bibliotherapy as reading therapy encompasses both the use of “didactic” literature like self-help books and the broad category of “imaginative” literature, which can include fiction, poetry, drama, and biographical texts.

Experts agree that, although it is commonly used, the impact and relative effectiveness of bibliotherapy is difficult to quantify. Research has shown mixed results, but outcomes support bibliotherapy as a valuable adjunctive therapy for physical and mental health issues and an option for those who don’t respond to traditional therapeutic methods. Meta-analysis shows that it may be “more effective for certain problem types (assertion training, anxiety, and sexual dysfunction) than for others (weight loss, impulse control, and studying problems).”

Bibliotherapy has played a larger role in professional depression treatment than in many other conditions. Some research suggests that bibliotherapy for depression administered by a family physician may be just as effective as standard anti-depressant prescriptions. The study leaders noted that their findings present an economically efficient alternative for patients who cannot afford ongoing prescription costs (or – my addition – who prefer a treatment that doesn’t include medication). Another study supported the relatively minimal need for follow up care in bibliotherapy applications for mild to moderate depression. Among 84 participants, those who received minimal telephone follow up contact saw essentially the same gains as the group that received more intensive phone-based follow up. Both groups experienced “significant reductions” in their depressive symptoms in comparison with the control group.

In a different objective, bibliotherapy has also been studied and applied to boost “cognitive reserve,” the intellectual “skills and repertoire” that can stave off the cognitive decline inherent to conditions like lead poisoning and multiple sclerosis.

Researchers suspect that at least with didactic literature, individuals must be interested in receiving help for bibliotherapy to be an effective treatment. Imaginative literature, however, is another animal entirely. Although there is little to no hard data for direct comparison, some experts hold (PDF) that imaginative literature displays more consistent success in bibliotherapeutic applications. In the words of Jessamyn West, “Fiction reveals truth that reality obscures.” The “emotional impact” of imaginative literature, they say, surpasses the rational examination elicited by most didactic self-help works. Not only does the backdrop of fiction or poetry offer a more nuanced illustration of life experiences, but readers often come to identify with the characters in a deeply resounding way. The emotional experience of following the character’s trials and outcome can crack open readers’ defenses. Within the safe but compelling confines of a book, readers can find themselves and their life’s issues laid bare. The characters’ development, realizations and catharses become seed for their own.

Whether in the depictions of fictional characters or the supportive voice of didactic literature, I venture to say most of us at various times have found ourselves galvanized by our reading material. In those solitary hours absorbed in the folds of printed pages, we envision a different life for ourselves and find inspiration that eludes us in the course of our daily lives. Although a relative few of us may be on the receiving end of professionally guided bibliotherapy, the concept touches anyone who’s ever picked up a book. As many of you mentioned in response to the “Flow” article a couple of weeks ago, reading – particularly fiction or poetry – represents a retreat like no other and a common catalyst for those liberating flow experiences.

Whether it’s divorce, illness, depression, or loss, we all face dark times in our lives. Even during our calmest periods, the heavy questions of life and tragedies of others can weigh upon us. We seek comfort and sense – not necessarily easy answers but encouragement, direction and finally confirmation that others have gone through what we’re thinking and experiencing.

In books, we look for other means of comprehending our problems or the complexities we question in the world. They expand us with their novel perspectives and emotional force. They simultaneously illuminate our individual circumstances and affirm the essential commonalities of humanity. They offer us alternative settings and narratives against which we can observe the substance and delineations of our own identities. Other times books provide a simple but much needed escape. For an hour or so, we can try on the lives of literary figures or poetic voices and leave behind our own burdens and limitations. We inhabit another outlook or existence and return both fortified and fulfilled for the creative venture.

Thanks for stopping by today. Be sure to share your thoughts on bibliotherapy – and the books that have inspired you along the way. Have a great week, everybody!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Thanks for this wonderful post. I’m a librarian and a practicing bibliotherapist with my own company as well — I enjoyed the way you’ve laid out this article so clearly. You are right that there is a difference between ‘clinical’ bibliotherapy practiced by mental health professionals which uses self-help literature, and that of ‘developmental’ or ‘creative’ bibliotherapy which depends on the use of imaginative literature (which is what I practice). I look forward to your article on writing as part of bibliotherapy as well! Thanks for shining a light on this wonderfully accessible health-promoting activity.

    Melanie wrote on March 15th, 2011
  2. Hmm, I do love fiction, but for some reason, I tend to read almost always non–and by choice. Two nights ago I was reading in bed with tea, my PJ’s on and had just applied an awesome moisturizer—it was such a relaxing moment and I reflected upon it. Talk about simple pleasures! Yes, I do believe reading can be therapeutic. I actually think other storytelling–such as in good films–can be, as well.

    ObligateCarnivore wrote on March 15th, 2011
  3. What a thoughtful post. I can say this was a powerful tool for me when making dietary changes. When I was struggling with sugar withdrawls books like “Sugar Blues” really got me through. I dug in medical journals to answer my “why” questions about dietary response in autism and trying to understand how the GI and immune systems work. I guess that’s bibliotherapy.

    Tracee wrote on March 15th, 2011
  4. I love this article, Mark!

    Reading truly is the balm of life.

    And if you have never read Slaughterhouse Five, you have not truly lived!

    fritzy wrote on March 15th, 2011
  5. “Only Forward” by Michael Marshall Smith is the best book ever written. It has a genre all of its own: slipstream. :)

    I love reading, but I haven’t done much lately. I’ve dabbled a bit in “An Empire Unacquainted With Defeat” by Glen Cook, author of “The Black Company” series (which are freakin’ awesome if you love gritty fantasy).

    Patrick wrote on March 15th, 2011
  6. I’m reading Harry Potter right now, in French. I’ve tried on and off to learn a foreign language. And since I’ve started reading (and watching heroes in French too….) my comprehension has surpassed the level it was in High School

    next I plan to read LOTR, another classic I’m told

    Trevor Clack wrote on March 15th, 2011
    • I read HP in French too! It was right at my skill level. I found LOTR too hard though, good luck with it! (I can barely read it in English! :D)

      Ely wrote on March 23rd, 2011
  7. I really loved reading this post and all the comments. I took me a long time to enjoy reading. I was only recently diagnosed with a learning disability so now I know why I struggled with reading for so long. Now books are like magnets to me! It’s kind of makes me laugh thinking I just started a new business…in the book industry!

    FreeLife wrote on March 15th, 2011
  8. I love reading. I even went so far as to take a MA in comparative literature.
    But – all books are not created equal. I am sure, that if you were, say, depressed and read a book like ‘No country for old men’ or ‘The Road’ my Cormac Mccarthy, it wouldn’t exactly help.
    My curiosity was peaked: Is bibliotherapy just ‘go read a book you like’, or does the doctor/therapist recommend specifik books that address the issues someone i struggling with?

    Ulla Lauridsen wrote on March 16th, 2011
    • Ulla – a bibliotherapist will discuss the issues a person is facing and try to match specific books to that issue. A therapist would probably choose non-fiction, self-help to be read & discussed with them; a ‘creative bibliotherapist’ like myself would select novels/poetry/short stories in a style and/or genre you like that also deal with your issue in some way.

      Melanie wrote on March 24th, 2011
  9. By the way: My favorite to relax is Jane Austen. Pretty darn good books. Also, of course, Harry Potter.

    Ulla Lauridsen wrote on March 16th, 2011
  10. Our whole family read the Harry Potter series and rereads, and rereads! Our 11 year old LOVES to read and while I know that’s unusual today, especially for a boy, there are some really great kids series out there.

    For me, I always come back to Jane Austen and Maeve Binchy and Tom Clancy. I’m all over the place! Thanks much Mark!

    Lynn wrote on March 16th, 2011
  11. Hi Mark,

    Nice article again. I definitely need to balance my intake of non fiction up with more fiction. It is all good though, I have learned so much about health through books and now…through the web!

    Cheers Anthony

    Anthony Procopis wrote on March 16th, 2011
  12. What a great article! Really inspiring.

    I love my fiction and do really enjoy Tolkien and Harry Potter, as others do. For fantasy lovers looking for humour (or humor if you prefer!) the Terry Pratchett books are well worth trying- very funny. Also, I would really recommend Tad Williams books- he is a great storyteller and they are thoroughly absorbing!

    John wrote on March 16th, 2011
  13. There is nothing like the weight of a book in hand, the feel of the pages between fingertips, the smell of the paper and the places that book takes you while you relax on the couch.

    I have watched empires crumble, wandered through lush green jungles, survived a plane crash in the middle of no where, swam to the depths of the ocean, found the meaning of life, feasted with vampires, hid from Soviet soldiers and explored all corners of Xanth several times over. No where else, can you find the time to do all of this except between the pages of a book.

    Excellent article Mark, books have been my therapy since I first started reading the printed word.

    Bunnyfoot wrote on March 16th, 2011
  14. Reading is so good for the spirit and the soul! So many great books and authors have already been mentioned but wanted to add current favorite fiction author to the mix – Haruki Murakami. He is an Japanese author that weaves fantasy and surrealism into everyday life – he is a very gifted storyteller!

    Some of my favorites of his are: Hard-Boiled Wonderland at the End of the World, Kafka on the Shore, and A Wild Sheep Chase.

    Amber wrote on March 16th, 2011
  15. Great post, Mark.

    Some of my favorites:
    Pilgrim At Tinker Creek, Annie Dillard.
    The Corrections, Jonathan Franzen.
    Walden, Henry David Thoreau.
    The Animal Dialogues, Craig Childs.
    The Road, Cormac McCarthy.
    Everything Is Illuminated, Jonathan Safron-Foer.

    Kevin wrote on March 16th, 2011
  16. I always have a book on CD in the car. It helps keep me from road rage, stress and aggravation that can come with a long commute.

    I don’t always have time to actually “read” like I’d like to so it’s a nice substitute. I do love those days curled up on the couch with a good book, though.

    Real Food Mama, I’m a huge fan of all those, too! Just finishing up Mockingjay this week. :D

    Sonya wrote on March 16th, 2011
  17. Reading “Watership Down” can probably prevent cancer.

    J wrote on March 16th, 2011
  18. This is why I love this website: great articles and great commenters!
    I am a voracious reader and have recently started reading some graphic novels. I used to be opposed to reading books with pictures. Now I am digging it!
    On a side note; I love books so much, I have a stack of three books tattooed on my back.
    Also: I think I just figured out what I want to be “when I grow up”–a bibliotherapist! (Is there such a thing?)

    Jenni wrote on March 16th, 2011
    • >> I have a stack of three books tattooed on my back <<

      That has got to be the BEST tattoo ever!

      J wrote on March 16th, 2011
    • Have you read Diana Gabaldon’s graphic novels? I loved her “typical” books. :D I imagine the graphic novels are also amazing!

      Sonya wrote on March 16th, 2011
  19. The Power of Now changed my life! I was brought out of a fog of thinking. This book actually allows you to be more in touch with your instincts, and therefore more primal. Thanks Mark!

    Anthony Giametta wrote on March 17th, 2011
  20. In my next life I think I may come back as a book. I’m not sure what genre yet. My favorite book is “The Alchemist” Paulo Coelho. I just recently discovered this at a used book sale at my local library. I read it in about half a day and I read snippets of it every day since.

    Lauren wrote on March 17th, 2011
  21. This is awesome!
    I have always been a bookworm. These days I ride public transit so I usually have at least 30min/day to read. (awesome!) I’m getting tons of ideas from other people’s favorites! I mostly like sci fi & fantasy, that stuff with the “hope” element, nothing too dark or heavy. I’m reading the Foundation series right now – can’t believe I never read it before!!! having just re-read I, Robot and Dune. Planning to tackle the rest of the Dune series as well. Love Anne McCaffrey, Harry Potter, and quirky little mysteries like those by Ngaio Marsh, Josephine Tey, and of course Arthur Conan Doyle. ;)
    A word in favor of the e-reader. I too love a paper book, and usually have one or two in my bag. However, the e-reader is the salvation of a quick reader on a long trip – even paperbacks get heavy and bulky, but with my e-reader I carried over 40 books on a recent flight. In addition, because I am cheap, I discovered a whole world of books out of copyright, available free, that I never knew about. Bonus.

    Ely wrote on March 23rd, 2011
  22. I’ve just noticed this myself. Self-help books and motivational books just don’t help as much as a really good novel.
    I just finished rereading DragonSong and DragonSinger and they really make me feel a lot better.

    Stephan F- wrote on March 28th, 2011
  23. A.E. Houseman’s poem “Terrence, this is Stupid Stuff” has to do with precisely this topic: the therapeutic effects of poetry, specifically, and literature in general.

    Tony Pivetta wrote on March 28th, 2011
  24. A few years ago you wouldn’t catch me raeding a book. Sure I bought them, but usually only did it to have them (books). It wasn’t until I started reading “Rich Dad Poor Dad” that I actually became immersed in books. I guess that book really set me off and got me involved more with reading. Since then I’ve probably read and bought nearly 100+ books. I have a small library in my apartment and I don’t have enough room for all my books. I read everynight and it’s not uncommon to see a stack of books on my nightstand. I agree books are definitely awesome. There are plenty of times I’d rather just stay home and read because I get lost in those books. It’s quite inspirational to read, least for me. I rarely read fictional books, I mostly like reading biographies and inspirational books (like Think and Grow Rich, 4 hour work week, etc). I’m also an avid fan of WWII era books. I’m a “Creatively inclined” person, and love the idea of sharing stories, fictional or not. So to me reading is wonderful.

    Jonathan wrote on April 1st, 2011
  25. The Consolations of Philosophy by Alain de Botton, awesome read and great help :)

    theodora wrote on August 13th, 2011
  26. For an escape from the light-weight fast-food diet of trash literature today, which seems to suck in many even of those who have realized the value of quality stuff in your stomach – maybe the brain comes next – I recommend the following:

    -Shogun by James Clavell. This is the novel that made Medieval Japan (samurai, katanas, seppuku, geishas, kimonos, the architecture) popular in the West. It is also a mini series in twelve episodes, which you can download. James Clavell wrote about people’s personalities like no one else.

    -Tai-Pan, also by James Clavell. About Dirk Struan in Hong Kong in the 19th century, leading the most powerful trading house in Asia. Again, an exciting read and great depth in personalities.

    -A Princess of Mars by Edgar Burroughs. This short novel from 1912, and the novels that came after in the same series, is what a great deal of sci-fi thereafter is based on: Superman, Star Wars, Stargate, etc. His language is often very beautiful, and when you read it, you realize what you have been missing if you’ve only been reading today’s trumped-up trash literature.

    -Growth of the Soil, by Knut Hamsen. Written in 1917, which gave him the Nobel Prize in literature in 1920 – that was before it was politicized and handed out to leftist weirdos. Growth of the Soil is about a farmer in Norway. He walks into the wilderness with his tools and builds a house for himself out of nothing, and then raises a family there. Anyone who has gone primal should read it. You may think it sounds boring, but the story is fantastic, and the lessons are of a kind all children should learn – without making the book lecturing.

    -Call of the Wild, by Jack London. Naturally. The lessons of the wild, and of life, told through the eyes of a sled dog in Alaska. One of the books that you have to read.

    Carpenter wrote on March 10th, 2012
  27. “I think we ought to read only the kind of books that wound and stab us. If the book we are reading doesn’t wake us up with a blow on the head, what are we reading it for? …we need the books that affect us like a disaster, that grieve us deeply, like the death of someone we loved more than ourselves, like being banished into forests far from everyone, like a suicide. A book must be the axe for the frozen sea inside us.”

    Frank Kafka wrote on May 4th, 2012
  28. thank u

    nikhila wrote on January 4th, 2013
  29. Reading fiction books has always been difficult for me. I’ve always been drawn to non-fiction books they help me feel productive. This post makes me realize I need to give fiction a fair chance.

    Does anyone have any good suggestions for a good fiction book anyone would love?

    Chad wrote on February 19th, 2013

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