Bibliotherapy

The Interactive Process A Handbook

Arleen McCarty Hynes

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429728549
• Edition: 1
• Topic: Medicine
• Subtopic: Psychiatry & Mental Health

The recognition that literature can be a healing tool is as old as Aristotle's discussion of catharsis. In bibliotherapy an individual reads or listens to a work of literature specifically for its therapeutic value. But until now a real professional tool was lacking. This handbook, the first of its kind, is designed to teach both professionals and laypersons how to use the whole spectrum of literature—from poetry to science fiction—to promote greater self-knowledge, to renew the spirit, and, in general, to aid in the healing process. Beginning with an explanation of the theoretical basis for bibliotherapy, the authors then provide a comprehensive overview of the procedures and goals of the discipline. The material is presented in such a way that the process may be adapted to the particular educational or psychological approach favored by the practitioner for the therapeutic treatment of individuals who have been abused or are chemically dependent, physically disabled, emotionally disturbed, hospitalized, in correctional institutions, or simply facing difficult or stressful life situations. The authors also offer insights for using bibliotherapy to promote the healthy growth and development of children and to provide psychological help and guidance to adults and the aging. Case studies from practice and training experiences illustrate the principles of bibliotherapy; in addition, the authors include end-of-chapter study questions for persons involved in therapy and self-help and practicum guides for professionals. Taken together, these materials comprise a unique and invaluable reference work in a new and significant field.

Part 1
Basic Understandings

1
Interactive Bibliotherapy: A Definition

Chapter 8 of Alexander Solzhenitsyn's Cancer Ward is an almost perfect introduction to the interactive nature of bibliotherapy.

Like all the other patients on his ward, Yefrem Podduyev is racing death from cancer. He is very restless and disagreeable until he finds a little blue book from which he reads Tolstoy's story "What Do Men Live By?" The title voices the question that Podduyev finds himself struggling with because of his illness. Using the story as an impetus, he goes around the ward asking everyone that same question. He gets a variety of answers, none of which really satisfies him.

But as he responds to and reflects on these replies, Podduyev comes to a much deeper understanding of Tolstoy's answer—the answer that he wants the others to acknowledge—that men live not by worrying about their own problems but by loving others. After the discussion, Podduyev stops stomping around the ward for hours on end, haranguing the other patients. Instead he lies quietly on his bed, thinking about his past and the meaning of the story.

WE SEE HERE THE INTERACTION of the three key elements in bibliotherapy: Although he is a peer rather than a trained guide, Podduyev acts as a facilitator; Tolstoy's story is the literature; and the other patients on the ward are the participants in this group. At the same time, we see the result of an effective bibliotherapy session. The dialogue about the question posed by the story leads several members of the group to reflect and to arrive at a fresh view of life. In Podduyev's case at least, that insight is internalized and leads to a change in behavior.

The features we have just identified here are found in the working definition of bibliotherapy used in this handbook: "Bibliotherapy uses literature to bring about a therapeutic interaction between participant and facilitator."

Schools of Thought About Bibliotherapy

We should admit from the start that bibliotherapy is a somewhat problematic term. If nothing else, the polysyllables are cumbersome, and bibliotherapy does not communicate an immediate general impression in the way that the names of other creative therapies, such as art therapy or dance therapy, do.

Nonetheless, this is the term used in many professional indexes. Besides, the etymology is meaningful: Biblio- means books and, by extension, literature; -therapy comes from therapeia, meaning to serve and to help medically, and it suggests the concept of healing. Basically, then, bibliotherapy is the use of literature to promote mental health.

This particular capacity of literature to renew and heal the human spirit is at least as old as Aristotle's discussion of catharsis in the Poetics. However, bibliotherapy should not be considered as an umbrella term for all activities in which books are used for self-improvement. Its use in that way results from confusion (and even disagreement) about exactly where the healing process is centered.

Reading bibliotherapy

One school sees the healing process as taking place through reading itself. This mode is a direct development from the traditional role of the librarian as provider of readers' advisory services. In the early 1920s, as an outgrowth of this activity, some librarians made a point of searching out and offering reading materials specifically for their therapeutic potential (Bryan 1939). Since then, numerous librarians, counselors, English teachers, and social workers have compiled lists and made suggestions for reading they believe will help an individual's emotional growth or offer insight into a personal crisis.

In 1949, Caroline Shrodes's dissertation seemed to confirm the definition of bibliotherapy as a process in which an individual reads a book selected specifically for its therapeutic potential for that person. Although her discussion made it clear that the critical interaction was not in the suggestion of the book itself but in how the reader used the content, her definition is still used in some circles to equate bibliotherapy with the process of "prescribing books." We, however, would like to see this activity differentiated as reading bibliotherapy.

We do not mean to suggest that recommended readings cannot serve therapeutic ends. On the contrary, there are many cases in which a librarian, teacher, or counselor's thoughtful suggestion has provided a reader with just the right book—a work that triggered a significant and growth-producing feeling-response to some need. The point is that the interaction takes place between the reader and the work and does not directly involve the person who made the suggestion.

Interactive bibliotherapy

We feel it is important that the benefits of the reading process itself not be confused with the distinctive benefits that Shrodes herself suggested would come from discussing the reader's response. Our handbook reflects the thinking behind Rubin's (1978a) and others' recent definitions of bibliotherapy. According to these definitions, there is a significant therapeutic dimension to the facilitated dialogue about the individual's feeling-response to the literature. In other words, in this mode—which can be identified as interactive bibliotherapy—the process of growth and healing is centered not as much in the act of reading as in the guided dialogue about the material.

In effect, the triad of participant-literature-facilitator means that there is a dual interaction: The participant's personal response to the story is important, but dialoguing with the facilitator about that response can lead to a whole new dimension of insight. Burt (1972) concisely reviews the literature on this point.

Our emphasis on the therapeutic role served by having feelings clarified in a discussion led by a trained facilitator reflects our understanding that interactive bibliotherapy is more than a potentially healing suggestion—it is a therapy. Moreover, we share Jerome Frank's perspective on the nature of therapy:

Viewed ss a healing art rather than as a form of reeducation, the most effective ingredients of psychotherapy lie in those aspects of the therapeutic relationship which raise the patient's morale and inspire him with courage to try new ways of coping with the stresses that beset him. These healing components lie in the realm of feelings. Arousal of such emotions as hope, faith, reverence, even sometimes fear, characterize all forms of healing in nonindustrial societies. Such emotional states seem to increase accessibility to the healer's influence and facilitate attitude change. . . . Proponents of all schools of psychotherapy have always agreed that purely intellectual insight is of little value. (Frank 1972, 110-111)

Thus, in bibliotherapy, the possibility of growth comes from confrontation with genuine feelings. However, raw feeling in itself is not the significant factor. Rather, the beneficial integration that interactive bibliotherapy offers comes from the cognitive process of first recognizing feelings and then sorting out and evaluating the feeling-responses. The process, moreover, is one that is helpful to all—not just to those diagnosed as mentally ill. As T. V. Moore said in discussing his work with adolescents, "The object of bibliotherapy is to supplant impulsive desires by truly human conduct in which one is conscious of the end towards which one is striving, knows what is worthwhile and is determined to attain it" (Moore 1946, 138),

Interactive bibliotherapy and poetry therapy

The recognition that literature can be a formal healing tool reflects a third tradition. In the 1920s, psychiatrist Smiley Blanton, M.D., and his associate, Eli Grieffer, began to propose poetry as a tool that could be used in accordance with a specific methodology. Calling their mode poetry therapy, Blanton and Grieffer argued that poems have tremendous potential for use in the diagnosis of important emotional issues; however, they pointed out, it can be difficult—particularly for the emotionally disturbed—to work through such issues unaided. Thus, in poetry therapy an important part of the healing process comes from the communication between therapist and client about how the chosen work bears on the individual's problems and needs (Blanton 1960).

A number of psychotherapy practitioners soon began using creative writing by the client in addition to poems as the basis for both diagnostic and therapeutic sessions (Leedy 1969, 1973; Lerner 1978). We, too, will refer at times to other current therapeutic approaches that use writing, reading, and/or discussion of stories or didactic material but that do not identify themselves as bibliotherapy or poetry therapy.

As the increasing use of the term biblio/poetry therapy indicates, poetry therapy and interactive bibliotherapy are synonymous in most critical respects. Both emphasize the importance of the interaction between the triad of participant-literature-facilitator as well as the use of creative writing as material. In this book, however, we use the term bibliotherapy because it is generally accepted as a more inclusive term than poetry therapy.

Comprehensive Features of Bibliotherapy

Definition of literature

In bibliotherapy the term literature is not restricted to poetry or creative writing but, rather, is used in the broadest possible sense. Poetry may be the form used more often than any other; nonetheless, bibliotherapeutic materials encompass not just imaginative but also didactic and informational works. Plays, short stories, novels, essays, magazine articles, and sections from textbooks can all be used in their entirety or in abridged form; so, too, specific passages from any of these forms can be extracted for use.

In fact, the bibliotherapist does not restrict literature to the written word. In our world, audiovisuals are an important expression of people's thoughts and feelings. Therefore, recordings, films, videotapes, and filmstrips have all been successfully used as material for bibliotherapy sessions. The added dimensions of sound and/or visual images can increase the impact of language.

Although our definition covers the full spectrum of genres and media, we do feel that all bibliotherapeutic material should involve language and have some internal coherence. Thus, whereas photos, paintings, and music are frequently used to intensify the effect of a written text, of themselves they are not suitable material for a bibliotherapy session. So, too, it will not do to present a group with a list of random words or phrases in order to stimulate free association. We will see that the bibliotherapeutic process depends at least in part on the way the participants relate to a stimulus that has its own coherence and integrity.

The facilitator's background and choice of setting

Bibliotherapy facilitators have a wide variety of backgrounds and can choose to operate in two quite different settings. As we have noted, the original poetry therapists primarily used a one-on-one relationship between psychotherapist and client. Some poetry therapists and bibliotherapists continue to use this format. However, bibliotherapy is more commonly practiced in a group setting.

We refer often to group needs and experiences throughout this book, but the point to remember is that the bibliotherapeutic process and goals function primarily in terms of the individuals who make up the group. By the same token, the facilitator's primary concern is with the needs of the participants as individuals rather than with the group as an entity. We will discuss the factors influencing the choice of setting more fully in the context of the bibliotherapist's responsibilities (Chapter 8).

Populations in clinical bibliotherapy

Because the populations that benefit from interactive bibliotherapy are so diverse and because the emphasis necessarily varies from one kind of group to another, practitioners now distinguish between clinical and developmental bibliotherapy. Clinical bibliotherapy is typically one of several creative therapies being used with populations in a specific treatment program. The facilitator is trained to use a psychotherapeutic methodology in which literature acts as the primary tool to help the clients) toward an integrated personality.

Strategies for dealing with the needs of specific groups will be discussed later, but here we can list the main populations a clinical bibliotherapist might expect to work with.

Emotionally disturbed persons. These clients will be in mental institutions, will be coming back for treatment and follow-up, or will be receiving independent professional treatment. They recognize bibliotherapy as part of their contractual arrangement for therapy. Brown (1977), Crootof (1969), Edgar (1979), Esler (1982), Hynes (1978a, 1978b), Lack (1982), Miller (1978), and Sweeney (1978) describe different hospital programs, whereas Leedy (1969, 1973) and Lerner (1978) detail work with individual patients. Fogle (1980), Mazza and Prescott (1981) and Mazza (1981) indicate the ways in which bibliotherapy has been used as a technique in family therapy.

Clinical bibliotherapy groups are usually formed on the basis of specific populations. For example, one group will be limited to emotionally disturbed adolescents, another to chronically hospitalized patients, and a third to patients who are also suffering from a physical handicap such as blindness or deafness.

Correctional institution residents. Bibliotherapy may be part of a prison program or required as part of probation and parole. Cellini and Young (1976) and Rubin (1974) describe bibliotherapy programs in a prison setting. Norman and Brockmeier (1979) report on the bibliotherapy program developed by Susan Brockmeier for use with youth in a state detention facility in Kearney, Nebraska.

Even though members of this population usually participate under mandate rather than on a voluntary basis, the bibliotherapist will usually insist on the principle that no one can be coerced into revealing personal feelings and insights. The emphasis in prison groups is on helping the participants better recognize and conform to society's norms and standards of behavior. But the bibliotherapist should realize that the participants can also be emotionally unstable and that, in such cases, bibliotherapy may contribute to psychological healing.

Chemically dependent persons. Clinical bibliotherapy groups have been a successful element of institutional drug and alcohol dependency rehabilitation programs (Mazza 1979; Gladding 1979; Goldfield and Lauer 1971; and Schecter 1983). Participants in treatment for dependency are usually intensely involved in self-evaluation and tend to respond effectively to the use of imaginative and informational material as a stimulus for probing their thoughts and feelings.

Populations in developmental bibliotherapy

Developmental bibliotherapy, which has emerged as a way to help all kinds of people in their normal growth and beneficial development, grows out of the recognition that the need to confront personal feelings, to improve self-awareness, and to enhance self-esteem is not confined to mentally ill patients, criminals, or chemically dependent persons. In general, participants in developmental bibliotherapy have specifically chosen this mode to further self-understanding.

Developmental bibliotherapy is typically practiced in groups that have formed and meet in the context of a school, community center, library, church, or synagogue. The basic techniques used to facilitate such groups are the same as those used in clinical bibliotherapy, but the depth of the therapeutic probing differs. At the same time, the bibliotherapist often plays a less active role in the discussion phase than is desirable in clinical groups. Some of the major populations that have successfully participated in developmental groups include the following.

Adolescents and children. The literature about developmental bibliotherapy is filled with references to programs designed for the young. Schultheis (1969, 1972) is a reading specialist who uses bibliotherapeutically oriented reading and discussion to help build self-esteem among those who need special reading help. Robinson (1980) works with special-education classes in a public library, whereas Frasier and McCannon (1981) use the approach with gifted students. Berg-Cross ...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• List of Tables and Figures
• Acknowledgments
• Introduction: A Reader's Guide
• Part 1: Basic Understandings
• Part 2: Literature: The Tool of Bibliotherapy
• Part 3: The Bibliotherapist
• Part 4: The Participant
• Afterword
• Appendixes
• Β. Bibliotherapists' Records
• C. Professional Organizations
• Bibliography of Professional Literature
• Bibliotherapeutic Materials Cited
• Index