Bibliotherapy: Books as Psychological Treatment?

November, 2020
Allison Zhao, Blog Correspondent
Allison Zhao is in her fourth year writing for Acta Victoriana, which she has been doing since the beginning of her undergrad at U of T. She loves reviewing books, always appreciates cafe recommendations, and probably has a pen you can borrow.

“Can reading make you happier?” Ceridwen Dovey asks in the headline of her 2015 article for the New Yorker, where she describes her experience with bibliotherapist from the London-based School of Life. At its most basic, bibliotherapy, or book therapy, uses reading as a method of emotional and psychological support. Dovey was gifted an appointment with bibliotherapist Ella Berthoud, who sent her a questionnaire to help establish Dovey’s needs, including the question “What is preoccupying you right now?” Dovey wrote back that she was concerned about not having the “spiritual resources” to be able to weather grief when it inevitably arrived in her life. With this in mind, Berthoud sent her a list of books to help guide her through this worry. Given the amount of time it might take one to get through the prescribed books, a follow-up appointment is not always required for book therapy; Dovey writes that it took her a “couple of years” to get through the list, as she mixed it in with her regular reading interests.

From a library at ancient Thebes with the inscription that it was “a healing place for the soul,” to Freud using stories in his psychoanalysis sessions, the idea of using stories as healing has persisted for centuries. Author George Eliot reportedly relied on books to help her get through the death of her partner, and in the aftermath of the First World War, librarians were trained in recommending books to help veterans cope with trauma. The more modern version that bibliotherapists like Ella Berthoud practice focuses on the power of books – often fiction, though non-fiction can also be prescribed – to transform. Bijal A. Shah, a book curator and bibliotherapist, explains that her selection process for books involves making sure that an individual can identify with the text or a character, and notes that the text should help the reader better come to terms with their own situation or emotions.

Book therapy can be categorized in different ways, including clinical bibliotherapy and the more social or educational version. Clinical bibliotherapy involves the more typical idea of therapy and is undertaken by professionally trained psychologists and doctors, often in conjunction with talk therapy. One suggestion for why bibliotherapy is not widely known is that it is not usually performed on its own in clinical practice – when implemented, it is an addition to another form of treatment. Social bibliotherapy, meanwhile, can be found in activities in libraries, prisons, retirement homes, and community centers. These programs are not specifically targeted at mental health and are not intended as substitutes for professional help, but instead are meant to improve resilience and well-being. They might involve group read-aloud sessions, encouraging members to respond to various aspects of the text, and have been connected with reducing symptoms of depression, among other illnesses. Shah also describes using book therapy in education, teaching school-aged children and teens strategies for resilience and helping them better understand milestones in their development.

In Ceridwen Dovey’s case, she writes that her ability to withstand grief was fortunately not called upon by the time she wrote the article for the New Yorker. However, the insights from the books in her reading prescription had helped her through periods of severe physical pain, demonstrating that at least in her experience, bibliotherapy had had some noticeable benefits. Earlier this year, another article about personal experience with book therapy was published on Buzzfeed. In February 2020, Clare Aston was looking for support for her “real, intense worry about the future,” and she went to Germaine Leece, who is a specialist counsellor at the Sydney Women’s Counselling Centre, and formerly a book editor. Her book prescription for Aston included texts related to understanding how life moves on and finding stability within oneself.

In May, Aston posted an update on her experience. The world had changed drastically in the space of just a few months, and Aston’s reasons to worry about the future certainly had reason to get even worse. Because of this, she wrote that it was hard to say whether the prescribed books had really been able to help her anxieties, and she found that her concerns from when she had first met with Leece now seemed “trivial.” In general, though, she appreciated that reading the books had diverted her attention, at least temporarily, from news reports that could be continually distressing. As well, in the process she found that she had been opened up to different authors and methods of storytelling, which widened her horizons for later reading.

Currently, bibliotherapy is of interest to Dr. Hoi Cheu, a professor in the English department of Laurentian University. He works with hospitals (including Toronto’s SickKids) to conduct research into bibliotherapy and is working on two book projects related to the concept. Cheu was quoted in a 2015 National Post article as saying, “We now have scientific observations to demonstrate that cultural activities can change brain structures. After decades of cultural construction theories, we can now reunite with the scientists to investigate a biological approach to literature.” In practice, however, bibliotherapy lacks traction in Canada today, as there is no certification process for therapists and relevant educational resources are somewhat rare. As a result, librarians and educators may be hesitant to get involved in a profession like this without having any kind of accreditation, and these concerns are valid.

Dr. Keren Dali, an associate professor at the University of Denver, writes that it is extremely important to acknowledge that librarians are not in a position to diagnose mental health issues in readers, offer books as a method of treating disorders, or handle readers’ potential negative reactions to the content. While it is perfectly fine for your local librarian to recommend books that address certain topics, readers may be very vulnerable when looking for relief from trauma or difficult life situations. In these cases, some topical books can be dangerous for them, and a librarian is not equipped to address these readers’ emotional needs. Dali continues on to say that the “lists of therapeutic books” that can easily be found online are misleading, in that they are simply related to particular topics, but cannot be relied on to be helpful and not actively harmful to the reader.

It seems from the experience of Ceridwen Dovey and Clare Aston, bibliotherapy in clinical practice produces some mixed results, and the long-term effects are hard to measure. Social bibliotherapy and generally sharing the reading experience may also be beneficial, but readers and educators should continue to be careful about recommending books without experience in therapy or treating mental health. Books have the potential to be very powerful, and perhaps they can make you happier (as Dovey’s headline wondered) but must be shared and handled with care.

While it is perfectly fine for your local librarian to recommend books that address certain topics, readers may be very vulnerable when looking for relief from trauma or difficult life situations. In these cases, some topical books can be dangerous for them, and a librarian is not equipped to address these readers’ emotional needs.

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