DH Lawrence once wrote, “One sheds one’s sickness in books.” It’s something anyone who loves reading will attest to: sometimes getting lost in the pages of a good book can be just the cure you need for a broken heart, a stressful day at work or frazzled nerves.
Bibliotherapy, a blend of the science of psychology and the art of literature, is having a comeback as a therapy. The idea that books can help make people feel better has long been entrenched in human history. The ancient Greeks placed an inscription above a library entrance calling it a “place of healing for the soul”. Plato said that the Muses gifted us with the arts as “an aid to bringing our soul-circuit, when it has got out of tune, into order and harmony with itself”.
By the 20th century, Sigmund Freud was using literature during his psychoanalysis sessions, while literature was prescribed as treatment for hospital patients in the US and England during the First World War.
Today, projects such as the UK’s Books on Prescription, where doctors can prescribe works of literature to treat people suffering from mild to moderate mental illness, or programs of therapeutic reading groups held in hospitals, prisons and public libraries, are following in this tradition, showing that reading can offer relaxation, mental stimulation and new perspectives on life.
“For people who enjoy reading, it can be an excellent way to de-stress,” says Jacinta Wassell, clinical psychologist at the Black Dog Institute, one of Australia’s leading bodies in the treatment and prevention of mood disorders.
“Taking time out to enjoy a good book not only provides a healthy distraction from the stresses of daily life it also offers a chance for your body to relax, helping ease muscular tension and frazzled nerves.
“Depending on the individual, they may prefer to become engrossed in a fictional story, one that captures the imagination and inspires creativity. For others, they may select a self-help type of book that offers step-by-step suggestions for managing mood and anxiety problems.”
Reading & the brain
The theory that reading has health benefits has been tested in numerous studies. Researchers are increasingly finding that picking up a good book can improve your mood, reduce stress levels, calm nerves, stimulate creativity, encourage empathy and ease the tension in muscles and the heart.
Cognitive neuropsychologist Dr David Lewis, from the UK consultancy Mindlab International at the University of Sussex, for example, found that just six minutes of reading silently can lower stress levels by more than two-thirds, slowing the heart rate and reducing muscle tension.
“Losing yourself in a book is the ultimate relaxation,” Dr Lewis says. “By losing yourself in a thoroughly engrossing book you can escape from the worries and stresses of the everyday world and spend a while exploring the domain of the author’s imagination.”
In this study, reading was tested against other forms of relaxation and found to be 68 per cent more effective at reducing stress than listening to music, 100 per cent more than drinking a cup of tea, 300 per cent more than going for a walk and 700 per cent more than playing video games. This effect is most believed to be due to the concentration that reading requires, compared to other relaxing activities.
Says Dr Lewis, “This is more than merely a distraction but an active engaging of the imagination, as the words on the printed page stimulate your creativity and cause you to enter what is essentially an altered state of consciousness.”
Part of the reason for this is that reading is not a passive activity; as MRI scanning confirms, it stimulates the whole brain. John Stein, emeritus professor of neuroscience at Magdalen College, Oxford University, explains: “When we get lost in a good book, we’re doing more than simply following a story. Imagining what’s happening is as good at activating the brain as ‘doing’ it.”
In other words, when we read and imagine experiences described on the page, our brains simulate real experiences. A 2009 brain-imaging study revealed that the same areas of the brain that process real-life experiences are activated when we read about sounds, smells, tastes and sights, creating new neural pathways just as if we were living these experiences ourselves. This doesn’t happen when we’re watching TV or playing a computer game.
One of the simplest ways reading can be used as therapy is through self-help books, Jacinta Wassell says: “There is evidence from numerous studies that self-help reading can benefit those suffering from mild to moderate depression and anxiety, by improving their mood and resilience to stress.”
With a huge range of books available relating to all kinds of psychological problems, including eating disorders, anxiety and mood disorders and alcohol and substance abuse, self-help reading can provide people with new insights into the way they are feeling and ways they can improve their state of mind.
“[Self-help] books may offer specific information about a particular disorder or detail strategies that can be learnt and applied by the reader to help overcome their current problems,” Wassell says. “It can also be helpful to read about another person’s experience with the disorder and how they have successfully coped with it. In this sense, reading can normalise a patient’s experience as well as offer reassurance.”
Books offering step-by-step guidance for overcoming a particular disorder are typically from a cognitive-behavioural perspective, which teaches strategies to manage negative thoughts.
“These sources of information can help the patient modify negative patterns of thinking or unhelpful behaviours that may be maintaining their disorder,” says Wassell. “By working through these books in a systematic way, patients often describe a stronger sense of personal responsibility for their recovery.”
However, when using self-help materials to treat a mental disorder, it’s important to choose a book that’s appropriate for your situation and that has been supported by research. Wassell advises discussing recommendations with a doctor, psychologist or other health professional before beginning any self-help treatment. She also recommends that these books be used in conjunction with ongoing support from your doctor or psychologist in order to get the most out of the treatment.
A fictional cure
“The self can get help from a book,” wrote the British poet and author Blake Morrison in his influential 2008 Guardian article The Reading Cure, “but the best kind of help doesn’t necessarily come by way of self-help books. Nor are the books which make us feel good usually feel-good books.” Rather, he points towards fictional classics — literary texts that address existential concerns — as a way of finding solace and perspective.
Dr Dale-Elizabeth Pehrsson, dean of the College of Education and Human Services at Central Michigan University in the US, has spent more than 10 years researching the therapeutic benefits of reading. She says reading great fiction can help us to feel we’re not alone and also mediate our experiences by giving us different models of human thinking and feeling.
“Bibliotherapy can promote increased self-awareness,” Dr Pehrsson says. “It can help clarify emerging beliefs and values. It can help with the development of one’s own ethnic or cultural sense of self and identity and belongingness to groups.”
This belief in the therapeutic benefits of imaginative literature underpins the UK’s Get Into Reading program, a pioneering project established in 2001 by Jane Davis, founder and director of The Reader Organisation. Delivering programs all over the UK in prisons, care homes, hospitals, mental-health facilities and public libraries, Get Into Reading prescribes a list of the classics, among them Rebecca by Daphne du Maurier, Great Expectations by Charles Dickens, Jane Eyre by Charlotte Brontë and Of Mice and Men by John Steinbeck.
State Library of Victoria project co-ordinator Susan McLaine, who is also a PhD candidate in the topic of bibliotherapy, was greatly inspired by this program when she managed a similar project, The Book Well Program, in 2010.
“Fiction really has the ability to capture someone’s imagination when you read it aloud to them, whether they are someone who normally enjoys reading or not,” McLaine says. “It’s a creative process when you’re listening to it and that opens up your imagination and your mind.”
A collaborative project between the State Library of Victoria, the Public Libraries Victoria Network and VicHealth, The Book Well Program followed the Get Into Reading model with a pilot series of read-aloud reading groups, targeting people in vulnerable situations across Victoria: the homeless, long-term unemployed, new arrivals to Australia, residents in aged-care facilities and people experiencing mental health problems.
“The text is really a tool for allowing a glimpse into the self and that happens when the spotlight is on the text and the characters, not the person in the group. The discussion is about the characters, so when you read slowly there’s time to think about the characters and how it relates to them, so the self comes in in another way,” McLaine explains.
“In a good story the characters speak for us, because we recognise their emotion — sadness, joy, anger, frustration — and we feel it when the character gives us the right words to articulate or express that emotion. I think it relieves us when we find the exactness in a written word of what we are feeling and that we are unable to express ourselves.”
During the sessions, trained facilitators read texts aloud to the group, pausing at certain points to ask open-ended questions that encouraged reflection and communication with one another. Often, this opened up conversations about childhood or other personal experiences — things that many participants wouldn’t have felt able to discuss in other circumstances. Participants, including those who did not consider themselves readers and thought they wouldn’t enjoy being read to, reported feeling better after sessions.
“The therapy happens when groups focus on the text, rather than on themselves and their problems,” McLaine says. “This state of consciousness assists group members to be open to new ways of thinking. As we begin to think differently — regularly — we can begin to look at problems of living in a different way.”
How to read for wellness
The most important part of reading for therapy, McLaine says, is learning to slow down the reading process. This allows space for the readers to engage closely with the text and to open up the possibility for thoughts and reflections connected to their own lives.
“Reading slowly gives you time to think about the characters and about how what’s happening in the story links to you,” she says. “If you read too fast you wouldn’t have that processing time.”
The read-aloud format of the group helps facilitate this deliberate pacing and McLaine says often the act of being read to had a calming effect on the pilot groups: “These groups need to create a safe and gentle space and one of the ways to do that is to slow the reading down and bring that soothing quality to it. When you think about it, a lot of us can remember being read to by our parents when we were children and that was usually done in a loving way, so sometimes it can subconsciously trigger that calm and relaxing feeling.”
While she says it’s easier to reach this state of consciousness in a group format, McLaine agrees it’s certainly possible to achieve these therapeutic benefits when reading alone for escapism and enjoyment.
“When someone is reading solo, they can learn to slow down their reading and spend some time stopping and looking at what’s going on the text. You could ask yourself, ‘How do I feel about that? How does it relate to me?’ By asking yourself those questions and being honest with yourself, that’s how you can open yourself up to different ways of thinking.”
Books on prescription
Clinical psychologist Jacinta Wassell suggests the following self-help books as an introduction to learning how to untwist your negative thoughts and improve your mood.
- Change Your Thinking by Sarah Edelman
- Beating the Blues by Sue Tanner and Jill Ball
- Overcoming Depression by Paul Gilbert
“These are all based on Cognitive-Behavioural Therapy and approach the treatment of depression in a systematic way using reputable psychological techniques — and all the authors are psychologists as well,” Wassell says.
“There are also a number of autobiographies of people who have suffered from depression and, depending on the background of the reader, there is sure to be a book that will resonate with their experience.”
The UK’s Get Into Reading program has used a wide range of classic and contemporary texts for reading therapy, including:
- Jane Eyre by Charlotte Brontë
- Of Mice and Men by John Steinbeck
- The Mayor of Casterbridge by Thomas Hardy
- The Pursuit of Love by Nancy Mitford
- The Secret Garden by Frances Hodgson Burnett
- Rebecca by Daphne du Maurier
- Uncle Tom’s Cabin by Harriet Beecher Stowe
- Adam Bede by George Eliot
- Great Expectations by Charles Dickens
- Zen and the Art of Motorcycle Maintenance by Robert Pirsig
- The Beach Café by Lucy Diamond
- Big Stone Gap by Adriana Trigiani
- Cider with Rosie by Laurie Lee
- Life with the Lid Off by Nicola Hodgkinson
- Prodigal Summer by Barbara Kingsolver
Rebecca Howden is a writer and editor based in Melbourne, Australia, with a strong interest in literature, arts and health. See more of her work at rebeccahowden.com.au.