South Indian CBT practitioners use book therapy to treat mental traumas

What is bibliotherapy?

Books as powerful tool to solve mental health problems. (Creative Commons)

Experts define bibliotherapy as a counselling approach where literature, in different forms — such as poetry, novels, short stories or plays — is used to arrive at a better understanding of the client’s life.

The therapy is also used to encourage the clients to take actions that can enrich their lives.

CBT practitioner Harinakshi Prabhakar from Chennai told South First, “The word ‘bibliotherapy’ was coined a century ago by a Unitarian minister Samuel Crothers. He, in an article in the Atlantic Monthly, described how relevant books can be used as an effective psychological treatment.”

Dr Ashwini explains there are two approaches to bibliotherapy.

In the first, existing literature is used to process certain aspects of the client’s life.

Second, the client creates something literary in nature — a poem, story, journal, etc. — to express what is happening in their life or to come to terms with something that happened in their life.

CBT practitioners told South First that bibliotherapy can be used to treat both developmental issues and clinical issues of clients.

“I use Developmental Bibliotherapy mainly in schools. There are certain kinds of books that are used to help children address issues like bullying, jealousy, peer pressure and make them understand the importance of teamwork and self-care,” Dr Nandini N, CBT trainer from Bengaluru, told South First.

On the other hand, the Clinical Bibliotherapy is used along with other psychological therapies to treat mental health conditions like anxiety or even post-traumatic stress disorders.

As a stand-alone therapy

Meanwhile, doctors say that bibliotherapy can be used as a stand-alone therapy.

A study in 2004 compared the effectiveness of self-administered bibliotherapy with traditional short-term (12-20 sessions) psychotherapy for 60 older adults diagnosed with depression.

The researchers found both techniques to be effective in reducing depression.

“We tell the client to read particular books which they are likely to identify with. Book-reading is made a part of the prescription,” Premanath Naik, CBT practitioner from Visakhapatnam, told South First.

Naik explained that the clients identify with a situation or a character in the book and that would help them understand themselves better.

Doctors, however, warn against the use of bibliotherapy without guidance.

They say that the first step of this therapy is to identify the problem of the client. A one-on-one counselling session or group of people dealing with similar issues can read and respond to texts together.

Books helps in handling various mental health issues. (Creative Commons)

Professional practitioners should guide the session as they know what questions to ask the client about the characters in the book.

The second step in the therapy is called catharsis, where the client’s emotions are engaged with the story, and the client can release their own emotions through the reading process.

In the final step, discussion, the therapist holds a discussion with the client about the best ways to handle their situation.

This is when they understand the client’s personal feelings and help them find solutions.

Bibliotherapy activities

Dr Ashwini told South First about the two bibliotherapy activities she developed.

The first, “Tell the title of your tale” technique, where the therapist asks the clients to think of a title for their autobiography if they wrote one in their current circumstances.

“Imagine if the client says ‘The journey towards the unknown’. Isn’t it suggestive of something the client is going through right now?” she asked.

“As a therapist, you do not assume anything regarding the intent behind the title. Instead, you help the client explore the reasons for choosing that title and, in turn, learn about their life. You could do several variations of this activity,” she said.

Dr Ashwini said that there could be many variations to these questions. The therapist could ask what the client’s loved ones would name his autobiography, or what would be the title if their significant others wrote a book on their life.

She added, “Or you could ask, if life turned out to be exactly as you envisioned 10 years from now, what would be the title of your autobiography?”

“You could ask similar questions to gain insights into their aspirations, concerns, and their perspective towards themselves, others, and life in general,” she said.

Bibliotherapy to actualise dreams

Explaining her second technique, “My story with multiple endings”, she said, “In this activity, you encourage the clients to write their life story with multiple hypothetical endings.”

Here, the therapist encourages the clients to develop as many different plots and endings as possible.

“Somebody might say, they will live till the age of 80 years, retire, have five grandchildren and live in Darjeeling after being a blockbuster writer,” she said.

“The same person may think of another possibility. He may say that he would get admitted to a hospital due to alcoholism-related health issues at the age of 50, with no family support as he separated from them due to fights and conflicts mainly resulting from his addiction,” she added.

“As a therapist, you then explore which story plot they desire and aspire to actualise. Then, come up with an action plan for actualising it,” she explained.

Bibliotherapy is used to solve problems related to anxiety, depression, bullying, inter-personal relationships, self-doubt, emotional avoidance, trauma, abuse and anger.

Dr Ashwini, however, warned that bibliotherapy must be performed with caution and only when the therapist has an awareness of how to process it in order to facilitate healing.