Bibliotherapy – Cedar Sanderson
A meta-analysis of the utilization of, and reading recommendations for effective bibliotherapy in a non-clinical setting.
Bibliotherapy is the use of reading to improve mental health, reduce anxiety, and increase ‘mindfulness.’
Firstly, what is mindfulness? Psychology Today defines it neatly. “Mindfulness is a state of active, open attention on the present. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.” In other words, rather than flowing through life on autopilot, we pay attention to our surroundings, to the people around us, and more important, to why we react and feel the way we do. This self-analysis is vital to living in harmony with our self, and with others. A good thing. And reading can enhance it?
A study published in Explore: The Journal of Science and Healing, examines the result of a small pilot trial of only 37 people, finding that fully 89% of them completed it, and the majority reported a reduction in stress, anxiety, and an improvement in mindfulness and resilience. What were they reading? Materials on how to reduce stress, without training, simply given the material to read. This is interesting, but perhaps not appealing to the average reader.
I would insist that books which portray resilience and mindfulness in the characters, without being written specifically to instruct the reader in how to reduce stress and anxiety, are as efficacious in obtaining the desired result.
In the early 1800s when bibliotherapy was first being explored as a treatment (alongside other methods), “It will be useful, as soon as out patients begin to discover any marks of the revival of mind, to oblige them to apply their eye to some simple and entertaining book,” Benjamin Rush wrote. While this is evidently targeted at those who had broken down enough to become a patient, what if the bibliotherapy was instituted much earlier, with the idea of preventative care rather than palliative? In addition, the idea was not met with overall approval. Isaac Ray wrote that “Cheap novels and trashy newspapers are more a cause than a cure of insanity.” The therapy endured, though, and became much recommended whether it was simply to allow the weary mind to escape daily tedium, to meditate, or to seek self-improvement.
In 2012, a study in Clinical Psychology and Psychotherapy showed quite clearly that bibliotherapy was effective in cases of subthreshold depression. “The results indicated that cognitive bibliotherapy resulted in statistically and clinically significant changes both in depressive symptoms and cognitions, which were maintained at follow‐up. In contrast, placebo was only associated with a temporary decrease in depressive symptoms, without significant cognitive changes.” Subthreshold depression is difficult to define, and has no clear treatment. Most would term it merely a case of the blues. However, most young adults and adults would admit that this is a condition they have found themselves in at some point. Reading, it seems, is an effective self-therapy.
Preventative care, then can be helpful. The study I referenced above followed a group of people for a year. They were given books to read that were not challenging – a 6thgrade reading level – and rated ‘highly interesting.’ The participants then discussed their reading monthly.
The interactive facet of this therapy seems to be an important part of it becoming truly effective for some, and for some purposes, although it is commonly carried out with private readings. A study of a Read-Aloud Group Bibliotherapy for the elderly: an Exploration of cognitive and social transformation, explored the use of group discussions to increase the mind’s ability to remember, endure, and heal
. “The idea that literature plays a role in healing has prevailed within nearly all human societies. From the distant past to the present day, humans have witnessed the extraordinary ability of literature to touch the soul, broaden the mind, enhance the imagination and invigorate the human spirit” (Katrina Genuis)
We are convinced, then, that bibliotherapy is a tool we can use in our own lives to improve our minds, our stress levels, and quality of life. How shall we go about this?
We can read to improve our minds, seeking out interesting books that instruct us without dwelling on ‘morbid thoughts’ (Galt, 1953). Historical books, references that improve our professional aspects, those can be part of the prescribed bibliography. Challenging our perceptions, too, is important. As is conversation about what we have read.
Beyond that is the use of reading for our physical health. Psychoneuroimmunology as described by Dr Gene Cohen is the phenomenon where stimulation of the central nervous system enhances the immune system. He reports that ‘an involvement in the arts associate with positive feelings triggers a response in the brain.’ His findings are supported by a study published by the University of Tokyo, which found in a two-pronged stufy of nearly 100 participants: “Study 1 revealed that participants felt more relaxed after reading positive poems with either personal or social content than after reading negative ones, and they felt least refreshed and calm after reading negative poems with personal content. Study 2 showed that participants reported less depressed feelings, both after reading an excerpt from an explanatory leaflet and after a controlled rest period.”
We conclude, then, that the content used for bibliotherapy is important. Negative, depressing, morbid, and nihilist materials are almost worse than nothing at all. For most, this is not surprising, as the twig is inclined, so grows the tree. However, an examination of popular literature shows that the quality for bibliotherapy must be considered. Dystopian, horror, or ‘literary’ fiction should be avoided. Instead, stories that offer insights into the resilience of the human character, which may go through a valley of despair but in the end offer hope and portrayal of personal growth, these should be offered for bibliotherapy. Uplifting personal stories, which can offer the reader a pleasant escape are not to be scorned, but rather sought out as a mental exercise in relaxation.
Through the pages of a novel, or a particularly well-done biography or historical sketch, the reader can find solace and solutions for their own struggles. However, the overly negative or heavy-handed treatments will not be effective. Choose the materials wisely.
Finally, discussion and group participation can be of further use in the alleviation of feelings of loneliness and irrelevance, and to help the reader become more socially active while stimulating their mind. Keeping in mind that a positive atmosphere is as important here as it is between the covers of the book, the group should be chosen carefully, and a route to withdraw from that group should be available if the dynamic becomes toxic. Online groups can be variable, with exiting them being simple, but they lack the face-to-face interaction that can be beneficial for the lonely.
In closing, consider this from a study carried out in Army Hospitals, “men bore their hardships more easily by reason of reading matter that either diverted or nourished them in some mysterious way.” (Jack and Ronan, 2008). What would you consider to be a nutritious book, then? A diverting one?
GENUIS, KATRINA. “Read-aloud group Bibliotherapy for the elderly: An exploration of cognitive and social transformation.” Journal Of Applied Arts & Health 6, no. 1 (June 2015): 77-89. Art & Architecture Complete, EBSCOhost (accessed August 23, 2015).
Macdonald, J., D. Vallance, and M. McGrath. “An evaluation of a collaborative bibliotherapy scheme delivered via a library service.” Journal Of Psychiatric And Mental Health Nursing 20, no. 10 (December 2013): 857-865. PsycINFO, EBSCOhost (accessed August 23, 2015).
Moldovan, Ramona, Oana Cobeanu, and Daniel David. “Cognitive bibliotherapy for mild depressive symptomatology: Randomized clinical trial of efficacy and mechanisms of change.” Clinical Psychology & Psychotherapy 20, no. 6 (November 2013): 482-493. PsycINFO, EBSCOhost (accessed August 23, 2015).
Morita, Haruka, and Genji Sugamura. “[Reading poems to oneself affects emotional state and level of distraction].” Shinrigaku Kenkyu: The Japanese Journal Of Psychology 85, no. 5 (December 2014): 437-444. MEDLINE with Full Text, EBSCOhost (accessed August 23, 2015).
Sharma, Varun, et al. “Bibliotherapy to decrease stress and anxiety and increase resilience and mindfulness: a pilot trial.” Explore (New York, N.Y.) 10, no. 4 (July 2014): 248-252. MEDLINE with Full Text, EBSCOhost (accessed August 23, 2015).