'It opened up something in me': Why people are turning to bibliotherapy

Here are some notable excerpts from the article:

1. It's people obtaining specific recommendations for books from 'experts' (sometimes at quite a hefty price!):

Some trace the origins of bibliotherapy to World War One, when fiction and non-fiction books were used to ease soldiers' suffering and trauma. But the idea made a return in the 1990s, Carney says. Today it takes many forms – from bibliotherapists like Berthoud who offer tailored recommendations for £100 ($130) per session, to some GPs who point some of their patients to fiction, like Andrew Schuman. He's an NHS physician who advises the bibliotherapy charity ReLit and co-wrote the 2016 Lancet paper about the benefits of bibliotherapy.

2. They acknowledge that not all books will be good for your mental health.

As anyone who has ever read and loved a work of drama, poetry or fiction can attest, stories have powerful effects on our minds and emotions. But that doesn't mean that any kind of fiction boosts mental health for everyone. Several experts interviewed for this article worry about what they see as an overhyped promise of creative bibliotherapy in treating specific mental health conditions, where they say the scientific evidence is still rather thin. In fact, research suggests that certain books can even be harmful.

...And, worryingly, some research has found that certain types of fiction can cause harm. In a 2018 study, Troskianko collaborated with the UK eating disorder charity Beat to survey almost 900 people, most of whom had experienced an eating disorder. They were asked how reading fiction books had affected their mood, self-esteem, diets and exercise habits and how they felt about their bodies. Surprisingly to Troscianko, when people recalled reading books featuring characters with eating disorders, it tended to worsen their symptoms. "If you've got an eating disorder, you're likely to at least perceive that the effects of reading that stuff for yourself were negative," she says. Worryingly, about a dozen participants said they even actively sought out such books, she adds.

3. Causation is not demonstrated.

Yet the evidence that reading helps mental health is complicated. Scientists have observed that, compared with non-readers, people who read regularly for pleasure tend to be less stressed, depressed and lonely, more socially connected and confident, and perhaps even live longer, as the psychological scientist Giulia Poerio of the University of Sussex in the UK summarised in a 2020 article. But, Poerio asks, "is it actually that reading fiction is improving wellbeing, or is it just the case that people with better wellbeing tend to be people who read fiction?"

4. It's most effective when readers reflect on and discuss the content of the book.

Carney agrees that merely giving people a novel won't have much effect; his research suggests that reflecting on books afterwards – especially together with other people – provides a much bigger wellbeing boost. Discussing literature gives people a way to think about distressing things that doesn't impinge on their wellbeing, Carney says. "When you're reading fiction, you're not bothered by Heathcliff or what Heathcliff's going to do, because Heathcliff is insulated from you by the fact that he's not real. Fiction gives you a way to rehearse all these difficult, challenging social scenarios," Carney says. And "if you can do that with other people, it makes it more real, it makes it more impactful".