We 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!