Stronger mental health

Mental health is a subject addressed in many novels and specialist books for children, adolescents and adults. But how visible are these books in the library when we need them most? And can reading fiction affect our mental health positively? Can therapy and literature function well in collaboration?

The library project Stronger mental health for children and adolescents is based on the idea that the library can promote health. The main objective of the project is for public libraries in Troms to display the range of information and literature related to the topic of mental health for children and adolescents. There is an inherent power in possing knowledge about one’s own situation, and literature may give access to understanding both ourselves and others.

Salutogenesis – the origin of health

The sociologist Aaron Antonovsky is the author of the term ‘salutogenesis’, formed by the words ‘salus’ meaning health and ‘genesis’ meaning origin. Antonovsky wanted to examine our ability to remain healthy more closely rather than what makes us ill. Why is it that some people tackle both mental and physical adversity without developing disease symptoms?

Salutogenesis deals with improving your own health through active participation. A range of factors can promote better health. The common denominator is the feeling of belonging, and being able to handle one’s own situation and to identify a meaning in it. Antonovsky’s theories have become part of a wider field, termed health-promoting work.

Many factors combine to give us good health. Some of these cannot be changed, such as what diseases we are susceptible to. But what we ourselves put into the sum total of our life experience is also important. What mental attributes do we possess that we can draw on when and if they are needed in times of crisis later? Are we able to use our experiences and knowledge when things get tough? It all depends on the setting or the context we find ourselves in.

Literature in the therapy room

The American family therapist Liz Burns has carried out research into the connection between literature and therapy. In her opinion the reading of fiction and the practice of psychotherapy can have a similar impact.

Both activities involve the intellect as well as the emotions, and require openness on the part of the individual. Even though therapy also includes a dialogue partner, she believes that therapeutic conversation with open questions and listening resembles reading more than other forms of dialogue.

So why not use literary texts in the therapy room, when therapy can be found in literary texts?

Therapy in literature

Literature professor Timothy Aubry has approached the subject of therapy in literature from a different angle. He claims that many readers select works of fiction not for their aesthetic qualities but for the opportunities they offer to help the reader at a personal level. He refers to the kind of books contemporary Americans choose to read: books that can provide strategies for confrontation, consolation, understanding or coping with personal problems.

Mr Aubry demonstrates that this manner of reading is typical of the American middle class and points to economic challenges in society as a possible reason for this development in the choice of literature. The middle class is struggling financially, and the differences between rich and poor are increasing. Choosing literature that can offer consolation, help or insight into the lives of others is perhaps not so surprising.

Bibliotherapy

Bibliotherapy represents a context where the reciprocal interaction between reader and literature sets focus on the reader’s personality so that literature becomes a tool for the therapist. Put in simpler terms: bibliotherapy is treatment through books, and arises in the interaction between the participant, the therapist and the literature.

Step by step the reader will attain a deeper understanding of his/her feelings and reaction patterns, and in the end will be able to assess and at best change whatever has been the breeding ground for problems. Thus literature will be a tool and catalyst in the change process.

Therapy in the library

It is a short step from the different theories of literature therapy and the active use of literature in the therapy room to the library’s role of guiding the reader. According to salutogenesis, good reading experiences end up in the sum total of our life experience and can be drawn on as needed. Our life experience also includes the feeling of mastery we derive from being able to read, as well as the value of having something we can use to fill our leisure time.

Liz Burns has the view that a fictional text dealing with the same topic as one is struggling with personally can help the reader to see the problem from the outside, thereby giving insight and new learning about one’s own life. Thus it is not what we read that is important but rather how we read. It becomes even more important to solve the reading code and to get beyond the technical aspect of reading and into the understanding of what we are reading.

It is perhaps unfamiliar for librarians to consider mental health explicitly but I believe this is already being done implicitly. “Do you have a book about death suitable for small children?” “Have you got a good novel about friendship?” Librarians are used to thinking about books according to theme. Librarians are thus also bibliotherapists in the widest sense of the word.

A need for love

One example of how reading can function as both health-promoting and therapeutic is Tromsø library’s work on book chat groups for young asylum seekers. When they attend the book chat group, it emerges that the books that other young people of their own age want to read – such as action, crime and thrillers – are not popular with them. Instead they want books and poetry about love, and books about being new or culturally different in Norway.

Acquiring Norwegian friends and finding love is definitely the most important aspect judged by the books they request. Liz Burns believes that literature can offer a bridge between one’s present life and what it is possible to achieve. These young people’s desire for love and closeness is thematised and highlighted by reading and talking about what they have read.

“Oh – I really wish I had a girlfriend!” a young boy exclaimed on one occasion. There is always a lot of smiling and laughter when we bring up the topic of love. But underneath there is deadly seriousness because many of them have a great need for love and care. Literature can help them to verbalise their needs.

Our experience with book chat groups for adult education students led to our wanting to continue this work in a separate literature group for young people in the evening. As a result we started up a weekly get-together with ‘an international profile’ in autumn 2013 for young people.

A project in the library 

On Tromsø library’s website the project has compiled its own webpages (www. tromso.kommune/sterkere) offering a thematic approach to searches on children, adolescents and mental health. Here various topics are gathered that lead directly to a qualified search on the topic in our catalogue.

Every month we link two changing exhibitions in the library to these topics, one for children and one for young people. In this way mental health will always be a visible topic in the library, even though the media collection is net-based.

The ‘Feelings’ collection is a bright red book box filled to the brim with books about feelings. These are mostly picture books for young children about all kinds of emotions. Here we draw on the excellent book series by the author and illustrator Anna Fiske, which is appropriately called Følelsesbiblioteket (The library of feelings).

Mental health is closely related to feelings, and talking about feelings can undoubtedly promote health.

Digitised letters

Over a period of 28 years the journalist Simon Flem Devold received letters from children and adolescents and answered them in the På skråss (On the Q.T.) column in Aftenposten, Norway’s largest newspaper. A considerable number of these letters and answers deal with all sorts of topics – from grief and depression to happiness and love. The letters have been digitised and catalogued by Lenvik public library, and are accessible on the website www. paskrass.no.

Through the Stronger mental health for children and adolescents project, the website has been completed and revitalised with a new layout, and relaunched. The letters in this database have something the fictional narratives lack – authenticity. The letters are real, and can give children and adolescents the opportunity to talk about and share their own feelings and experiences.

There are many approaches to the dissemination of mental health. Putting on plays in the library is a powerful tool. In autumn 2013 the theatre group Rimfrost gave a performance entitled Morten 11 år (Morten 11 years of age) in the libraries in Troms county. The performance was based on the book of the same name by Simon Flem Devold.

This is a warm, humorous and deeply serious performance about life and death. The actors engaged in a discussion with the audience after the performances, and reported many stimulating conversations during their tour of the county.

A health perspective

Our aim has been to show the potential that lies in using literature actively as a health-promoting activity. Our conclusion is that libraries have a mission that extends beyond simply offering literature for entertainment.

The project Stronger mental health for children and adolescents has given us experiences that others can benefit from. It is vital to develop library services from the health perspective – we have a lot to offer.

Librarian Tromsø Library and City Archives