Bibliotherapy

Reading And Wellbeing

As far back as Plato, storytelling has been a powerful way in which to mould the human mind. Plato questioned whether children should be permitted to hear any old yarn less their young minds be corrupted:

‘And shall we just carelessly allow children to hear any casual tale which may be devised by casual persons, and to receive into their minds ideas for the most part the very opposite of those which we wish them to have when they are grown up?It is most important that the tales which the young first hear should be models of virtuous thoughts…’ (Plato, 374 B.C., p.72)

I’m sure many of us can remember funny stories about nasty old trolls hiding under bridges or how Chicken Licken thought the sky had fallen in – moral tales told for the purpose of conditioning our little brains, to warn us of the perils in life, the house made from straw or the wolf hiding in grandma’s bed.

Would it be fair to say then that if a story can influence a mind, create a set of moral rules for life, a list of rights and wrongs, do’s and don’ts; it is also possible that a story could take a mind that is broken or damaged and re-wire the brain, rewrite life and fix or heal something that was broken or at least provide some understanding and relief?

For many people, reading can be a way to escape and whilst they are lost in another world the problems of their everyday reality, for a while can cease to exist. In many instances if our protaganist happens to be encountering experiences similar to our own, it can help us feel less isolated and can often expand our understanding of our own difficulties.

This then is one of the premises behind bibliotherapy, the therapeutic use of literature to help an individual understand and cope with an illness, or another problem, ‘the guided reading of written materials in gaining understanding or solving problems relevant to a person’s therapeutic needs’. (Riordan and Wilson (1989 pp.506-7)

This is not a new idea, in fact the term bibliotherapy was first used in 1916 by Rev. Samuel McChord Crothers in Atlantic Monthly where he talked about a bibliotherapeutic process, literature, both fiction and non-fiction was prescribed as medicine for a variety of ailments.

During World War One, Sadie Peterson-Delaney, a librarian established one of the earliest recorded formal programmes of bibliotherapy when she prescribed literature to WW1 veterans to boost their self-esteem and “relieve the mind from malady and worry” (Jack and Ronan, 2008)

In 1946 it was applied for the first time with children. Sister Mary Agnes, published a study on bibliotherapy for ‘socially maladjusted children’, stressing its use to help children overcome their problems. (Agnes, 1946, pp, 8-16) As the century continued, bibliotherapy has spread to a wide variety of therapeutic, educational and community settings.

But what is Bibliotherapy in 2010? There are different bibliotherapy schemes in operation today:

o Self-help bibliotherapy

"Self help bibliotherapy involves using non-fiction books based on cognitive behavioural therapy techniques to help people to understand and change their behaviour" (Brewster 2007, p.6). This form of bibliotherapy often involves a prescription element, frequently operating under the name of “Books on Prescription” (BOP). In the UK, schemes are typically operated by libraries, often in partnership with health care organizations like the NHS – Camden PCT have a BOP scheme in operation whereby GPs and other health professionals prescribe high quality self-help books to patients with mild to moderate mental health problems, which they are then able to pick up from six local libraries. There is strong evidence that self-help books can be effective in supporting people to overcome mental health problems. The Camden scheme is one of the first in London and follows an incredibly successful scheme piloted in Cardiff in 2003. With over 40 schemes running in the country, BOP is set to be a major agent of change in primary care mental health services.

o Creative bibliotherapy

"While creative bibliotherapy has the same aims as self-help bibliotherapy, it is a much more diverse service" (Brewster 2007, p.7). Hicks (2006) identified two models:
Library Based Bibliotherapy Model
Clients self-refer or are referred by health workers to library based bibliotherapists (e.g. trained librarians, counsellors, social workers, and teachers). Bibliotherapy takes the form of 1:1 and/or group based 'book chat' sessions.
The Reading Group Model
Clients self-refer or are referred by health workers to reading groups which may be serving a particular client group, e.g. mental health service users and which are usually linked to the public library service.

There are reading groups for people with learning difficulties, Alzheimers, motor-neurone disease and mental health problems, as well as for prisoners, excluded teenagers, looked after children and recovering drug-addicts. (Morrison 2008)

o Poetry Therapy

Poetry therapy is a form of creative bibliotherapy that has become increasingly popular since the 1960s. Whereas the focus on poetry as art is the poem itself, the focus of poetry for healing is self-expression and growth of the individual.

The majority of bibliotherapy schemes currently in operation in the UK are based on a self-help model. So what is the reasoning behind bibliotherapy? Aiex (1993 cited in Forgan, 2002) identifies several ways in which bibliotherapy can be beneficial:

o To show an individual that he or she is not the first or only person to encounter such a problem
o To show an individual that there is more than one solution to a problem
o To help a person discuss a problem more freely
o To help an individual plan a constructive course of action to solve a problem
o To develop an individual’s self-concept
o To relive emotional or mental pressure
o To foster an individual’s honest self-appraisal
o To provide a way for a person to find interests outside of self
o To increase an individual's understanding of human behaviour or motivations

Of course much reading is a personal experience, sharing reading experiences can be enjoyable, stimulating and can open doors to friendship. Reading groups engender an environment where social skills and confidence can blossom. The changes that arise from reading new information can alter the central and autonomic nervous system producing increased levels of endorphins, increasing hope and expectations, lessening feelings of isolation and self pity, assisting in planning, future thinking, problem solving, activating imagination and therefore creativity. (Dr H.F.Cheu) Perhaps the local ‘book group’ although not based on clinical principles does have its roots in a sort of therapy. The physical act of getting ready to go out, leaving one’s home, arriving for a group session, the discussion of material and psychoanalysis of character, the agreement or disagreement, the learning from each other, the sharing, the setting of a date for the future, the empathy between readers; all these ingredients create a mini-bibliotherapeutic environment. By the time one returns home, one feels as if one has been on a mini-journey of the mind; and one has had pleasure perhaps even joy.

‘There they hang in the wardrobe of our minds, the shapes of books we have read like clothes we have taken off and hung up to wait their season.’
(Virginia Woolf)

We wore that jacket, that book cover for a while, it went everywhere with us, on bus journeys, at the doctors surgery, at home, snuggled up in bed and then one day we came to the last page and in many instances there was sadness and yearning for more. The story had reached its final destination, it was time to say farewell, to close the chapter and with a deep sigh, caress the book and place it back on its shelf or take it back to the library or return to a friend. We have been on a journey with our characters, we’ve laughed together, wept, understood, felt angry, powerless, all this and more. And maybe like the lover lost in the distance of time – we fondly remember that period of sharing our emotions and how we loved them at the time and will never forget them, and of course they will always have a special place in our hearts. Our lives have become enriched, we have new knowledge, we may investigate further, new worlds become accessible, and our confidence may improve. And with the removal of that dusty jacket put back in the wardrobe or in the bag for the charity shop (because we don’t need it anymore) are we in fact also peeling back the onion skin, healing old wounds or hurts, have we shifted, moved on, put something to rest?

Below are some examples of reading lists:

Books on Prescription in Southwark
http://www.southwarkpct.nhs.uk/documents/3344.pdf
Books on Prescription in Hertfordshire
http://www.hertsdirect.org/infobase/docs/pdfstore/bopbklist.pdf
Telford & Wrekin Books on Prescription
http://www.shropsych.org/bopbooklist.pdf
Oxford Brookes bibliotherapy scheme (a scheme for students) http://www.brookes.ac.uk/student/services/counselling/selfhelp/bibliotherapy.html