Bibliotherapy: The Magical Healing Quality of Literature
Posted by Bijal Shah on
“I’ve never known any trouble that an hour’s reading didn’t assuage”. The words of French philosopher Charles De Secondat and author of the controversial book ‘The Spirit of the Laws’ continue to resonate today. Its premise is bibliotherapy, which is the use of literature as therapy. Biblio is the Greek word for books and therapy stems from the Greek word therapeia which literally means ‘to help medically’. The modern-day term ‘book therapy’ is often cited too, as is the word ‘bibliocounselling’, both describe the prescription of literature, as a form of art therapy, that enables greater self-awareness, cathartic relief and a better understanding of emotional, psychological, social and cognitive issues.
Whether we put a label on it or not, many of us cannot dispute the deeply pleasurable feeling and satisfaction we get, when we connect with literature that comforts us and resonates with us, whether that's fiction or non-fiction (e.g. memoir, biography, self-help books, essays) or other reading materials such as poetry. Bibliotherapy is an adjunct to the therapeutic process, prompting and often triggering emotions in us.
A Short History of Bibliotherapy
The first origins of book therapy or bibliotherapy can be traced back to the Ancient Greeks, who built libraries holding both entertainment and educational books. Aristotle’s literature was considered medicine for the soul. King Ramses II of Egypt also built a dedicated chamber filled with books that was aptly labelled “House of Healing for the Soul”, according to the Greek historian Diodorus Siculus, in his monumental work Bibliotheca historical.
In the early nineteenth century, doctors were prescribing books for guidance and respite from suffering and libraries were important contributions to European psychiatric institutions enabling the practice of bibliotherapy. In the early twentieth century, soldiers who were involved in World War I were reading to manage post-war trauma and many military hospitals had libraries attached to them to incorporate bibliotherapy, a large part of which was poetry therapy. There was a movement taking shape across both the US and the UK, that continued to build on bibliotherapy initiatives and resources (poetry therapy had been instrumental to the development of bibliotherapy). One such book as part of the Hospital Libraries book series, originally published in 1913 by Edith Kathleen Jones, is ‘A Thousand Books for the Hospital Library’ It was written ‘as a guide towards the selection of wholesome, readable literature for those who are ill either physically or mentally. While it has been compiled with the requirements of the latter class of patients in mind, it would seem no less suitable for the former, or, in fact, for any small library which desires only bright, wholesome, interesting books.’ It continues to stand as a work of cultural significance.
The practice expanded further in the 1950s when Carolyn Shrodes, author of ‘The Conscious Reader’ theorised that characters in stories can be hugely influential to those readers that identify with them.
Stoicism permeates much of Western thought and literature. In fact, the works of Seneca and Stoicism have led to the development of modern-day psychological studies including cognitive behavioural therapy (CBT) as documented by Dr Kelda Green whose research at the University of Liverpool in her book ‘Rethinking Therapeutic Literature’ . Dr Green also connected the significant impact and contribution of George Eliot’s work (as captured in her novels) to the foundations of modern-day psychology and psychotherapy. Eliot was attempting to fill a space where religion might have previously taken hold with the more scientific concepts of early psychology. She gave readers a language through which to express human emotion resulting from the complexity of human life both in terms of emotion and the difficulties of daily life.
Dr Green also cites Jules Evans’ book ‘Philosophy for Life and Other Dangerous Situations’as ‘a really helpful book, not just about stoicism, but about different ancient philosophies and how they are connected to the modern world — how they can be used, how they are being used and how they connect to different psychological kind of therapies.’ For example, cognitive behavioural therapy (CBT) stems from stoicism and the stoics and we discuss more of this history in our online Bibliotherapy, Literature & Mental Health.
A Definition of Bibliotherapy
At Book Therapy, we define Bibliotherapy as a form of art therapy that focuses on leveraging the power of stories to heal. Its power lies in the relationship that is formed between the reader and the writing (whether that is narrative, poetry or essay) and the reflection of the thoughts, feelings, observations and lessons that the writing provokes, through a daily journaling practice (referred to as ‘Book Journaling’), a bibliotherapy workbook or through a counselling session with a mental health professional or a bibliotherapist/librarian.
It can facilitate the recovery of people struggling with any form of emotional turmoil as well as more serious mental illness. The effectiveness of the treatment relies on the empathetic ability of the reader to identify with the literary text, either through its characters or the narrative itself. For example, a child who is grieving the loss of a loved one might read a story about another child who’s lost a loved one. Upon reading this they may no longer feel alone in their predicament. As it can be self-administered with literary self-prescription, it is seen as a cost-effective form of therapy, however, it's often combined with a therapy session led by a mental health professional (including a bibliotherapist, counsellor or psychotherapist) or a librarian or teacher.
How does it work?
The basis of modern bibliotherapy is two-fold. First and foremost, it focuses on the ability of the bibliotherapist to prescribe the appropriate books or texts for each individual (there’s no one size fits all and each book selected must be based on the reader’s personal choice and reading habits.) Secondly, it focuses on the reader’s own willingness to explore the value of literary thinking and find meaning within the literary language through self-reflection and journaling and/or discussion with a trained therapist.
The Three Pillars of Bibliotherapy (Prescribed Reading)
A literary text qualifies for bibliotherapy if it meets the following criteria:
A. Safety — the reader must trust the writing and feel safe to explore the feelings/observations that the literature provokes. These can be explored by either journaling or discussing it with a friend or within therapy (group therapy or individual therapy).
B. Connection — the reader needs to feel that their feelings are acknowledged and validated. They should feel a sense of connection to the author and the writing itself, relaxing their defences.
C. Action — the process should enable a sense of self-awareness, discovery, cathartic release followed by a plan to move forward. It should lead to self-motivated action to move forward either through a lesson learnt, a coping mechanism adopted or simply a release of emotions that have been suppressed and a sense of freedom and self-understanding filling the space.
The Bibliotherapy Process
There are three stages to the bibliotherapy process:
The individual needs to identify and connect with the text or relevant character.
The text needs to be able to help the individual connect with their emotion, allowing them to release these (i.e. provide for a ‘cathartic response’).
Provide insight into the individual’s own situation based on the issues faced by the character/discussed in the text and allow the individual to consolidate these in a therapeutic fashion.
Self-prescription or prescription by a bibliotherapist should integrate the above. A session with a bibliotherapist or trained psychotherapist alongside the prescribed text might also be beneficial for the reader, especially for more serious issues/mental health problems and should be considered at the outset for all bibliotherapy clients. Bibliotherapy spans both fictional and non-fictional literature across a variety of mediums. Fictional bibliotherapy (for example novels, poetry and tragedies) is a dynamic process, where the process of reading, interpretation and reflection is framed from the perspective of the reader and is where the work happens.
From a psychodynamic perspective, the effectiveness of fiction lies in its ability to lead the reader to identify with the literature, which then leads to cathartic relief and self-awareness and personal discovery. Looking at the world through the eyes of another character that you identify with provides the reader with a different way of looking at the same problem that is now shared - the sense of loneliness is eliminated through connection with text. Identification leads to empathy and the reader undergoes a catharsis, expressing the feelings that have been pent up and release any tension. Consequently, the reader is hopeful and behavioural change follows. Studies have also shown that talking about a character’s issues rather than one’s own is often easier to discuss and in hiding behind the mask of a character can allow us to work through our own issues more creatively (creative bibliotherapy).
What kind of issues can be treated with Bibliotherapy?
Bibliotherapy has been known to treat serious mental health issues such as depression as well as more moderate to mild issues such as stress, anxiety disorders, eating disorders and low self-esteem. It has also been known to promote psychological happiness, emotional relief and general mental well-being while also enabling personal development and self-discovery.
In the late twentieth century, bibliotherapy was a broadly used term however little was documented for research purposes. Many of the positive effects of bibliotherapy as an effective intervention have been reported since (see Christine Urquhart and Deborah Fanner’s Bibliotherapy for mental health service users Part 1: a systematic reviewin the Health Information and Libraries Journal) including those for treating self-harm, bulimia, obsessive–compulsive disorder (OCD), emotional disorders, shame-based addiction issues as well as providing comfort and hope for older depressed people.
Who Practices Bibliotherapy
Book therapy or bibliotherapy continues to be a powerful form of therapy that’s universally employed by librarians, mental health professionals working in clinical psychology and psychiatry, therapists, counsellors, teachers, doctors, social workers, other healthcare and medical professionals, parents, as well as spiritual and religious leaders. Its accessibility and cost-effectiveness, through the use of books/reading books make it a popular and convenient form of therapy — it’s also less intense than sitting down with a therapist in a therapy session. Consequently, many therapists and mental health professionals from all walks of life prescribe relevant books as part of their therapeutic approach or counselling session. Both the American Library Association andthe International Federation for Biblio/Poetry Therapy also have a wealth of resources that readers might find helpful from bibliotherapy reading lists to research.
Why Does Bibliotherapy Work?
Poems, Stories, Essays — they are versions of modern-day life be their fictitious or otherwise, and readers have the opportunity to vicariously experience the lives of other people, often re-experiencing a very similar emotion or feeling from a different narrative perspective, reframed — this is the magic of literature — because at this point catharsis occurs and repressed emotions are set free. This safe, trusting emotional space is key for the effectiveness of therapy enabling self-discovery, realisation of unmet needs, and our ability to optimise our lives through light-bulb lessons that offer meaning and purpose as the literature continues to illuminate our path forward, setting us free. It also gives us a voice and a language to represent our own experience which is what validates us. This is the power of literature. What’s fascinating and hugely inventive about bibliotherapy is that you could be reading the same story or poem for years and still receive a different or surprise interpretation that reframes the narrative in a new light — the novelty in itself can be invigorating, curative or enlightening, bringing deeper understanding and insight to our own interior lives and the exterior world.
Self-awareness, empathy and mental well-being
Reading is more than just voraciously devouring words as we hurriedly rush through the chapters of an engaging book that’s convinced us to stay up all night reading. It is the connection that we feel with the characters, the identification with those characters, the sense of comfort and the feeling of being understood. A 2011 study published in the Annual Review of Psychology confirmed that when people read about an experience the same part of the brain lights up as having experienced it themselves. This suggests that people who read a lot, tend to empathise better with others, and are able to accurately predict what someone else is thinking or feeling. As Virginia Woolf so aptly put it: “when we read we are in perpetual union with another.” Increasing empathy and self-awareness, reading promotes mental well-being, acting as a catalyst for positive behaviour change. Whilst reading may also give us a temporary but refreshing escape from the harsh realities of life, it enables short meditative pauses akin to small doses of medicine for daily stresses.
Reading Solo vs Group Reading
A UK charity The Reader also organises Shared Reading groups that facilitate the discussion of poems, short stories and novels, read aloud together (literature is not read in advance as you would expect in a traditional book club) which offers the ability to immediately discuss feelings, emotions and thoughts that are stirred up by the literature. This two-fold form of connection with both the literature and other people brings about healing through expression of emotional distress, which is often cathartic. What’s wonderful about the literature as observed by one of the reading-group members, is that beyond empathising with the literature and identifying the feeling you are literally re-experiencing feelings and emotions and as a result truly processing them.
Children’s bibliotherapy focuses on two types of bibliotherapy: educational and developmental, however children's bibliotherapy can sometimes be more complicated. Every child is different and what is demanded of individuals can be more nuanced — this is why the need for a trained bibliotherapist/good mental health professional is key in selecting books that are appropriate for the child at the time. There is no one size fits all. Often books are used to simply identify or draw out an issue that would be helpful for the child to talk about — particularly one that the child has been avoiding or ignoring. In addition for younger children, bibliotherapy is often combined with play therapy, to allow the child to express themselves in other words outside of verbal and written language which the child may not be able to do.
Secondly discussing issues in a narrative that the child may not be ready for, requires careful judgement and decision. There is also an argument for pre-empting a child’s development needs and educating them in advance about particular topics such as sex education and looking after our mental health. We term this as developmental bibliotherapy.
Depending on the severity of the issues, bibliotherapy and prescribed reading can be conducted by parents or teachers. For more severe issues, a child counsellor or psychotherapist may be better placed to prescribe appropriate texts and also provide follow-up sessions to monitor the effectiveness of these prescribed texts to heal.
‘Therapeutic stories’ have been hugely popular in the US. These are stories that are specifically written to help address a particular fear that a child has, with resolution guidance. The goal is for the child to build psychological resilience. These are also referred to as healing stories and the Healing Story Alliance have some fantastic resources in this space.
Bibliotherapy in schools
Teachers are master storytellers — they translate the lessons of everyday life into enjoyable learning through accessible vignettes tailored for the age and maturity level of the children that they teach. They are best placed to administer bibliotherapy both as a prescription tool but also as a way to learn about the children that they teach — working out their development needs, their strengths and their character (developmental bibliotherapy). This informs the teacher or the types of books that the student will connect with and which book(s) are appropriate for the child. The overall goal of children’s bibliotherapy should be to develop children’s cognitive, social and emotional skills at every stage.
7 Reasons Why Bibliotherapy in a Class Room Setting is Essential
Literature gives children syntax, language and vocabulary to understand the world and consolidate their knowledge but also to express how they are feeling. It gives them a voice, and helps them navigate the world.
Literature, books and characters provide children with an advocate, who represents them — their needs and what that are going through at the time.
Bibliotherapy is a teaching aid helping children learn about the world around them.
Bibliotherapy provides representation, diversity and equality. It introduces children to a colourful cast of characters, each with their own makeup, personality, needs, emotions and experiences. It helps children relate to the characters that are similar to them while allowing children to empathise with characters who are totally different to them.
Bibliotherapy is an excellent coping mechanism. It provides relief from emotional distress and helps manage anxiety and stress better. At Book Therapy, we use reading affirmation cards that establish the use of bibliotherapy and reading as a tool for children to managing the stresses and strains of life while also helping to establish a love of reading early on. These also provide support when parents or caregivers are not around.
6. This style of prescribed reading will also benefit the child’s development of self-understanding and self-awareness as well as empathy and problem-solving skills. In additional combining prescribed reading with creative writing and storytelling gives the child an opportunity to express and reflect on what they have read, identifying and adopting coping mechanisms for emotional and social challenges at school.
7. Group reading and discussion also facilitates the integration of various perspectives that may be missing from the interpretations of individual children, which again adds to their general understanding of the literature, the world and others. It’s also a key tool and facilitator for developing empathy.
Often distress cannot be managed alone — we may be aware of it, we may be very connected to what we are feeling. However for us to process it, we need a space for it — for it to take shape in a story that allows us to make sense of what happened, to make it meaningful and literature as a therapeutic medium has the power to do this — to help us navigate the suffering and challenges of life and free us from the pain and emotion. We often view our life as a story, and storytelling is an innate and unique part of humankind — let’s leverage its power.
If you’re interested in learning more about how bibliotherapy can help you, sign up to my online course, Bibliotherapy, Literature and Mental Health. The course provides a comprehensive guide on the practice of bibliotherapy using case studies of readers’ self-transformation through life-changing experiences of literature. At the end of the course, you’ll be able to use bibliotherapy as part of your own personal development and mental well-being or help other readers discover the life-changing magic of literature.
A big hello and thank you for reading! Passionate about literature, psychology, and life I launched Book Therapy as an alternative form of therapy using the power of literature. I train mental health professionals, librarians, teachers as well as readers on using bibliotherapy in their own work through ouronline Bibliotherapy, Literature and Mental Health course. We alsocurate reading lists/personalised book prescriptionsfor clients based on their individual needs. This is our signaturepersonalised reading service.
You can also check out Book Therapy’s otherfree reading listsand A- Z of book prescriptions(covering both fiction and non-fiction). These suggest books based on your existing life situation (e.g. anxiety, job change, relationship heartache) as well as interests (e.g memoir, historical fiction, non-fiction, crime etc). There’s also aChildren’s A — Z of Book Prescriptions. Feel free to check out theblogfor more literary gems. There’s also a post on mypersonal storyof how I entered the world of bibliotherapy and book curation.
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