HOW READING CAN AFFECT EATING DISORDERS – FOR BETTER OR FOR WORSE

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New research is trying to establish if books can help readers heal

Very little is known about whether readers respond in clinically relevant ways to literature. Now, new research is revealing the potential benefits and dangers reading can pose to those with eating disorders

Why do you read? Maybe you read to relax after a long day, to learn about unfamiliar people or places, to make you laugh or to let you dream. Maybe you never really ask yourself why, but turn to books out of some vague instinct that they’re what you want or need.

The question of why humans invest such a lot of time and other resources in reading is an interesting one for researchers of both minds and texts, especially when it comes to fiction and poetry, where the answer doesn’t seem as obviously pragmatic as just learning useful facts. Whatever the answer is, it promises to tell us as much about human nature as it does about literature.

For decades now, researchers in cognitive literary studies have been suggesting reasons for why we read fiction. The dominant thinking is some variant on the idea that reading (especially reading narratives, often fictional) is pleasurable because it serves some evolutionarily adaptive purpose, in particular by giving us the chance to honecognitive skills of one kind or another, free of real world risks. One strand of the general idea that narrative reading may increase our “fitness” is that it may quite literally help us be healthier.

Self-help books are an obvious place to start. There’s a growing body of research on “self-help bibliotherapy” (reading a self-help book, with or without some kind of formal guidance) which indicates that self-help books can sometimes be effective alternatives or supplements to other kinds of therapy.

But very little is known about whether readers respond in clinically relevant ways to poetry, fiction, or other narrative genres, such as memoir. The lack of evidence has not prevented a range of claims and theories from being proposed, and small-scale clinical uses of fiction and poetry by psychiatrists and psychotherapists seem to be fairly widespread.

So is the belief in art’s healing power just wishful thinking, or is there something to it?

Identification and insight

The focus of my work is eating disorders. To find out more about the effects of fiction reading in this context, I set up a partnership with the leading UK eating disorder charity, Beat. We designed a detailed online questionnaire to ask respondents about the links they perceive between their reading habits and their mental health (with a focus on eating disorders). The survey attracted 885 responses (773 from people with personal experience of an eating disorder).

We found that 69 per cent of those with personal experience reported seeking out both fiction and nonfiction to help with their eating disorder, and that 36 per cent had found the fiction or nonfiction they tried helpful. We asked people to rate the helpfulness and harmfulness of different types of text in relation to their eating disorder, and 15 per cent rated fiction about subjects other than eating disorders as more helpful than any other text type. At the same time, memoirs featuring an eating disorder were rated the most harmful text type, with fiction about eating disorders in second place. This suggests a complex set of effects.

How reading helps

But how does reading fiction actually affect health, positively or negatively? The dominant theoretical view holds that therapeutic effects arise out of a process involving identification (with the character or situation in the text) followed by insight (into the nature of one’s condition). This is perhaps accompanied by some kind of strong cathartic emotional response, followed by a problem-solving stage in which the insights are converted into intentions for personal change. This type of model usually requires that texts should portray situations as similar as possible to the reader’s own, and that they should provide happy but realistic endings.

There are many reasons to question this model. If reading about someone the same as yourself is meant to be therapeutic, what makes it different from, say, rereading your own diary entries? Does the concept of similarity become self-limiting at a certain point, and if so, at what point? And on what dimensions (nature of illness, age, sex, socioeconomic status) is similarity most relevant?

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