Bibliotherapy: How reading and writing have been healing trauma since World War I
Bibliotherapy – the idea that reading can have a beneficial effect on mental health – has undergone a resurgence. There is mounting clinical evidence that reading can, for example, help people overcome loneliness and social exclusion. One scheme in Coventry allows health professionals to prescribe books to their patients from a list drawn up by mental health experts.
Even as public library services across Britain are cut back, the healing potential of books is increasingly recognised.
The idea of the healing book has a long history. Key concepts were forged in the crucible of World War I, as nurses, doctors and volunteer librarians grappled with treating soldiers' minds as well as bodies. The word "bibliotherapy" itself was coined in 1914, by American author and minister Samuel McChord Crothers. Helen Mary Gaskell (1853-1940), a pioneer of "literary caregiving," wrote about the beginnings of her war library in 1918: "Surely many of us lay awake the night after the declaration of War, debating … how best we could help in the coming struggle … Into the mind of the writer came, like a flash, the necessity of providing literature for the sick and wounded."
The well-connected Gaskell took her idea to the medical and governmental authorities, gaining official approval. Lady Battersea, a close friend, offered her a Marble Arch mansion to store donated books, and The Times carried multiple successful public appeals. As Gaskell wrote: "What was our astonishment when not only parcels and boxes, but whole libraries poured in. Day after day vans stood unloading at the door."
Gaskell's library was affiliated to the Red Cross in 1915 and operated internationally – with depots in Egypt, Malta, and Salonika. Her operating principles, axiomatic to bibliotherapy, were to provide a "flow of comfort" based on a "personal touch." Gaskell explained that "the man who gets the books he needs is the man who really benefits from our library, physically and mentally."
Her colleagues running Endell Street Military Hospital's library shared similar views about the importance of books in wartime. On August 12, 1916, the Daily Telegraph reported on the hospital, calling the library a "story in itself." Run by novelist Beatrice Harraden, a member of the Womens Social and Political Union and also, briefly, the actress and feminist playwright Elizabeth Robins, the library was a fundamental part of the treatment of 26,000 wounded between 1915 and 1918.
"We learned," Robins wrote in Ancilla's Share, her 1924 analysis of gender politics, "that the best way, often the only way, to get on with curing men's bodies was to do something for their minds."
The books the men wanted first were likely to be by the ex-journalist and popular writer Nat Gould, whose novels about horseracing were bestsellers. Otherwise, fiction by Rudyard Kipling, Marie Corelli, or Robert Louis Stevenson rated highly. In the Cornhill Magazine in November, 1916, Harraden revealed that the librarians' "pilgrimages" from one bedside to another ensured what she called "good literature" was always within reach, but that the book that would "heal" was the one that was most wanted: "However ill [a patient] was, however suffering and broken, the name of Nat Gould would always bring a smile to his face."
The literary caregivers at Endell Street worked responsively, and without judgement, a crucial legacy.
Library on the frontline
Literary caregiving also took place closer to the front. Throughout the war, the YMCA operated a network of recreation huts and lending libraries for soldiers. After losing his only son, Oscar, at Ypres, the author E. W. Hornung offered his services to the YMCA. Hornung – a relatively obscure figure now, but a literary celebrity then – authored the "Raffles" stories about the gentleman thief of the same name.
Arriving in France in late 1917, Hornung was initially put to work serving tea to British soldiers. But the YMCA soon found him a more suitable job, placing him in charge of a new lending library for soldiers in Arras. Dispensing tea and books to soldiers helped him process his grief. Hearing soldiers talk about their favourite books played a key role in his recovery – but he also sincerely believed that reading helped soldiers keep their minds healthy while they were in the trenches. Hornung wrote in 1918 that he wanted to feed "the intellectually starved," while "always remembering that they are fighting-men first and foremost, and prescribing for them both as such and as the men they used to be."
Writing a new future
Present-day veterans encounter the potential of reading and writing in equally participatory ways as interventions with the charities Combat Stress UK (CSUK) and Veterans' Outreach Services demonstrate.
In CSUK, we read widely from contemporary work before undertaking writing exercises. These were designed to help provide detachment from the internal repetition of traumatic stories that some with PTSD experience. The director of therapy at CSUK, Janice Lobban, says: "Collaborative work … gave combat stress veterans the valuable opportunity of developing creative writing skills. Typically, the clinical presentation of veterans causes them to avoid unfamiliar situations and the loss of self-confidence can affect the ability to develop creative potential. Workshops within the safety of our Surrey treatment centre enabled veterans to have the confidence to experiment with new ideas."
Another approach, in workshops with Veterans' Outreach Support in Portsmouth in 2018, explored the role of writing in training veterans to become "peer-mentors" of other veterans wanting to access VOS services, ranging from physical and mental wellness to housing benefits to job-seeking.
The results show that veterans responded positively to opportunities for imaginative writing. Trainee peer-mentors responding to a questionnaire told us that the exercises helped them to write fluently about their own lives. For people who spend so much time filling out forms to access various benefits, the opportunity to write creatively was seen as a liberating experience. As one veteran put it: "We are writing into ourselves."
For 100 years now, reading and writing have helped veterans build relationships, gain confidence and face the challenges of their post-service lives. Our current research charts the influence of wartime literary caregiving on contemporary practice.