Literary reading and eating disorders: survey evidence of therapeutic help and harm

Quantitative methods for group bibliotherapy research: a pilot study

Background

Bibliotherapy is under-theorized and under-tested: Its purposes and implementations vary widely, and the idea that 'reading is good for you' is often more assumed than demonstrated. One obstacle to developing robust empirical and theoretical foundations for bibliotherapy is the absence of analytical methods capable of providing sensitive yet replicable insights into complex textual material. This pilot study offers a proof-of-concept for new quantitative methods including VAD (valence-arousal-dominance) modelling of emotional variance and doc2vec modelling of linguistic similarity.

Methods

VAD and doc2vec modelling were used on conjunction with qualitative coding to analyse transcripts of reading-group discussions plus the literary texts being discussed, from two reading groups each meeting weekly for six weeks (including 9 participants [5 researchers (3 authors, 2 collaborators), 4 others] in Group 1, and 8 participants [2 authors, 6 others] in Group 2).

Results

In-text-discussion similarity was inversely correlated with emotional volatility in the group discussions (arousal: r = -0.25; p = ns; dominance: r = 0.21; p = ns; valence: r = -0.28; p = ns). Enjoyment or otherwise of the texts was less significant than other factors in shaping the significance and potential benefits of participation. (Texts with unpleasant or disturbing content that strongly shaped subsequent discussions of these texts were still able to sponsor 'healthy' discussions of this content.).

Conclusions

Our methods and findings offer for the field of bibliotherapy research both new possibilities for hypotheses to test, and viable ways of testing them. In particular, the use of natural language processing methods and word norm data offer valuable complements to intuitive human judgement and self-report when assessing the impact of literary materials. We also share observations on facilitation protocols, interpretative practices, and how our group reading model differs from other trials of group reading for wellbeing.

Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction

Does reading fiction improve mental health and well-being? We present the results of five studies that evaluated the impact of five forms of exposure to fiction. These included the effects of recalling reading fiction, of being prescribed fiction, of discussing fiction relative to non-fiction, and of discussing literary fiction relative to best-seller fiction. The first three studies directly recruited participants; the final two relied on scraped social media data from Reddit and Twitter. Results show that fiction can have a positive impact on measures of mood and emotion, but that a process of mnemonic or cognitive consolidation is required first: exposure to fiction does not, on its own, have an immediate impact on well-being.

Representing young men's experience of anorexia nervosa: a French-language case study

This article analyses two young adult (YA) novels about young men's experience of anorexia nervosa (AN), within the dual contexts of medical humanities research into literary depictions of illness, and the broader field of YA literature about AN. While emphasising the importance of diverse literary narratives in order to raise awareness of the prevalence of AN in men and boys, and to contribute to the reduction of stigma, it also considers current research into the potentially harmful triggering effects of AN literature on vulnerable readers. It identifies Anne Percin's Point de côté (Side Stitch) (2006) and Simon Boulerice's Jeanne Moreau a le sourire à l'envers (Jeanne Moreau Has An Upside-Down Smile) (2013) as examples of good practice in AN literature, due to their thematic focus on male experience, and because they employ narrative strategies that disrupt reader identification with the anorexic character, and avoid focusing directly on potentially triggering descriptions of anorexic ideas and behaviour. They also contribute to diversifying the portrayal of AN via non-judgmental portrayal of lesbian, gay, bisexual, and transgender (LGBT) themes, a topic absent from equivalent YA novels currently available in English. The article further argues that literature-including fiction-contributes to the overall social and cultural discourse surrounding specific illnesses and is likely to affect patients' real-world experiences, but that it is a specific kind of discourse in its own right, which demands to be read with the appropriate tools. Its detailed analysis of narrative voice alongside thematic content demonstrates how specific approaches from the field of literary studies may complement empirical research into literature and its place within mental health discourse.

Culture and mood disorders: the effect of abstraction in image, narrative and film on depression and anxiety

Can cultural representations be used to therapeutic effect in the treatment of mood disorders like depression and anxiety? This article develops a theoretical framework that outlines how this might be achieved by way of mid-level cultural metrics that allow otherwise heterogeneous forms of representation to be grouped together. Its prediction is that abstract representations-as measured by Shannon entropy-will impact positively on anxiety, where concrete representations will positively impact on depression. The background to the prediction comes from construal level theory, a branch of social psychology that deals with the effects of abstraction on psychological distance; the types of cultural representations analysed include image, narrative and film. With a view to evaluating the hypothesis, the article surveys the empirical literature in art therapy, creative bibliotherapy and cinema therapy.

Treating Eating: A Dynamical Systems Model of Eating Disorders

Mainstream forms of psychiatric talk therapy and cognitive behavioral therapy (CBT) do not reliably generate lasting recovery for eating disorders. We discuss widespread assumptions regarding the nature of eating disorders as fundamentally psychological disorders and highlight the problems that underlie these notions, as well as related practical problems in the implementation of mainstream treatments. We then offer a theoretical and practical alternative: a dynamical systems model of eating disorders in which behavioral interventions are foregrounded as powerful mediators between psychological and physical states. We go on to present empirical evidence for behavioral modification specifically of eating speed in the treatment of eating disorders, and a hypothesis accounting for the etiology and progression, as well as the effective treatment, of the full spectrum of eating problems. A dynamical systems approach mandates that in any dietary and lifestyle change as profound as recovery from an eating disorder, acknowledgment must be made of the full range of pragmatic (psychological, cultural, social, etc.) factors involved. However, normalizing eating speed may be necessary if not sufficient for the development of a reliable treatment for the full spectrum of eating disorders, in its role as a mediator in the complex feedback loops that connect the biology and the psychology with the behaviors of eating.

Fiction-reading for good or ill: eating disorders, interpretation and the case for creative bibliotherapy research

Compared with self-help bibliotherapy, little is known about the efficacy of creative bibliotherapy or the mechanisms of its possible efficacy for eating disorders or any other mental health condition. It is clear, however, that fiction is widely used informally as a therapeutic or antitherapeutic tool and that it has considerable potential in both directions, with a possibly significant distinction between the effects of reading fiction about eating disorders (which may-contrary to theoretical predictions-be broadly negative in effect) or one's preferred genre of other fiction (which may be broadly positive). Research on creative bibliotherapy, especially systematic experimental research, is lacking and requires a medical humanities approach, drawing on knowledge and methods from psychology and cognitive literary studies as well as clinical disciplines to expand our understanding of how the dynamic processes of interpretation mediate between textual structures and characteristics of mental health and illness.