Wednesday, April 6, 2011

Bibliotherapy? Woo or Valid Practice?

I picked up my copy of American Libraries from the ALA today.  I came across a topic I’d never seen before: bibliotherapy. 

Bibliotherapy is defined simply enough as therapy with books.  It has some links to poetry therapy and is touted by some children’s librarians.  Apparently, it has a long history in the United States.  But something about it had my skeptic senses tingling near overload. 

I decided to conduct a simple search using Academic Search Premier-a general database I have access to through the University of Kentucky.  I typed in “bibliotherapy” into the search box and managed to get 374 hits dated from 1949 to 2011.  I narrowed the search by requesting only scholarly (peer-reviewed) resources.  This dropped the number of records down to 299 in that same date range.  To narrow the search again, I utilized the subject term “bibliotherapy” from the sidebar.  At this point, I had 184 results.  I decided to browse through the abstracts.

The abstracts discussed the use of bibliotherapy for childhood depression, adult depression, alcoholism, anxiety, gambling addiction, geriatric care, etc.  Several of the articles focused on the use of “self-help” books.  The other thing I noticed, and this is the biggie, is that most of the study abstracts indicated bibliotherapy only works, or works better, when it is combined with other means of therapy-like counseling or medication.  And some of the studies that indicated it did work were very small.  Before I’d buy this, I’d need large study groups and definite controls.  Compare bibliotherapy for depression against medication, and then show me the results. 

Now, don’t get me wrong.  I know reading and books open worlds and provide a wonderful means of engaging the mind and imagination.  They are great escapes.  They can be inspirational and pull readers out of the issues plaguing their minds.  However, I don’t think reading is necessarily the best way to fix mental problems.  And I really think “self-help” books are mostly a load of bull.  Reading fiction, true-life stories, biographies, textbooks, etc. all open up a reader’s world.  Books expand minds and introduce us to new ideas.  They show us worlds we might not otherwise be able to access.  But, self-help books? Really?  That’s what’s going to solve depression and anxiety?  Most of those books are wishy-washy and over-priced, telling readers to “look on the bright side” or “imagine your perfect life, and it’ll happen” or “mind over matter” and on and on.  Some of them talk about souls and angels and all manner of woo that won’t do your brain any good at all. 

Think about this for a minute.  Who decides what the main problem is?  Who selects the books?  Are we talking trained psychologists?  Or children’s librarians?  I think these issues are important.  I don’t want the local librarian psychoanalyzing and treating me or my kid.  I want a therapist or someone with credentials.  In some ways I can see bibliotherapy as harmless.  It’s like homeopathy that way.  It might not hurt even if it doesn’t help.  But then I think about the possibility that people with detrimental problems, not just teen angst or temporary depression, might be talked into bibliotherapy when what they need is counseling and medication.  That bothers me.  It bothers me a great deal.

My Hubby and I watched his brother go through depression and multiple attempts on his own life before he finally committed suicide.  A self-help book wasn’t going to help him.  Medication and therapy were helping, but there were other circumstances causing problems (we found out later).  This guy wasn’t illiterate.  He read, he painted, he was a pharmacist, he had a sense of humor and a love of fantasy and science fiction. 

And on another personal note, I suffer from minor depression and anxiety.  I’m a reader.  I’ve read the self-help books.  I’ve connected with characters going through similar problems.  But that didn’t get me over my problems.  You know what did?  Medication.  It gives me the mental space I need to be strong.  It stabilizes those wonky chemicals that get out of balance due to genetics and/or life circumstances.  We’ve all had days with the bad brain chemicals.  Some of us end up with more bad days than others.  It doesn’t even take an overly strong medicine or a high dose to balance me out.  But without that tiny chemical push in the right direction, I don’t balance.  And books become an escape at that point, not a way through my depression.

Now, those are my personal experiences.  I’m not an expert on this subject.  I haven’t dug through the studies.  My gut reaction to this and my reaction to the brief perusal of the article abstracts could be way off.  Maybe, bibliotherapy works.  But I need more convincing.  If any of my readers have any thoughts or info on this topic, let me know.  I’m in need of some educating.   

And to be fair, I have found one self-help item that actually helps.

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