This online toolkit is a collection of resources about using literature to support mental well-being at times of illness. It is particularly aimed at clinicians and medical students keen to incorporate the use of literature in clinical and reflective practice but may be of interest to a range of interested readers, academics and of course to those experiencing illness. The toolkit has been created collaboratively with clinicians, literature and humanities experts, and expert by experience groups. We are keen to collaborate further in developing this resource with other organisations.
This project explores the patient experience through the prism of literature and personal narrative to inform self-care, patient-centred care, and to support clinicians with regard to reflective and clinical practice while investigating interactions between literature and medicine. Do doctors and patients speak the same language, and how can we use narrative to bridge the evident gaps? This project explores the use of narrative in medicine and has an interdisciplinary focus.
This collaboration is led by Dr. Elizabeth Barrett and the UCD Child and Adolescent Psychiatry and Dr. Melissa Dickson at the University of Birmingham with the Diseases of Modern Life Project at St Anne’s College, Oxford.
Our activities comprise a series of explorations around the central theme of literature and mental health. The events are brought together by their intent to explore the best ways of drawing on the insights of historical and literary research in contemporary medical practice and the insights that medical practice lends to the reading of literary texts. We have now held two successful interdisciplinary MindReading events.
The first MindReading conference in 2017 was held at UCD and the Lexicon Library in Dublin.
Literary genres used in medicine are multiple and versatile, there are also various methods of using literature.
Genres:
Methods
Benefits
As we all know, many authors have described the use of literature in reflection about self, the practice of medicine, the patient experience and the therapeutic use of literature. Many efforts were put into identifying useful texts for busy clinicians. There are several genres of literature used in medicine. One approach may be the use of self-help books which are either recommended by doctors or independently sought out by patients. Other approaches may include autobiographies of the illness experience, which help readers, physicians and patients alike, to gain insight into subjective nature of the illness experience. Apart from reading literature, people also use creative writing and literature to illuminate the patient experience; the list about applications of literature can go on and on…There is also research around the effectiveness and different applications of literature in medicine.
Narrative medicine was introduced as a humane model for medical practice which requires narrative competence: “the ability to acknowledge, absorb, interpret, and act on stories and plights of others”. One of the methods to achieve narrative competence is through close reading of literature. This form of practice seeks to build a more empathic engagement between patient and physician, hence achieving a more productive therapeutic interaction (Charon, 2001). Not only that, reading literature can spur critical and creative thinking about the role medicine can play in contemporary culture (Oyebode, 2010)
Reading autobiographical accounts of the illness experience reminds physician readers about the unique individuality of the patient amidst the waves of objective biomedical reports (Oyebode, 2001)(Aronson, 2017). Reading these autobiographies allows readers to gain insight into the experience from the author’s point of view; in other words, to gain experiences without living through them. Consequently, this knowledge allows readers to have a greater capacity for empathy towards the people involved, patients and doctors alike, as well as being informed about how to behave appropriately around them. Apart from autobiographies, fiction also plays a role in reflective practice. It gives readers the unique opportunity to contemplate unconventional ideas, explore unusual scenarios and implications in medicine (McFarlane, 2017).
Close reading of literature can be done individually and autonomously by both patient and physician readers. In addition, patients who are prescribed bibliotherapy are encouraged to discuss about the reading experience with the physician.
Additionally, literature workshops have been used with healthcare professionals where the group does close reading of specific texts and engage in reflective discussions. In addition, literary studies are also integrated into medical education programmes; such as poetry courses in University of Birmingham, and medical humanities subject electives in Trinity College Dublin.
In conclusion, literature has an invaluable capacity to enrich medical education, clinical practice, and personal wellbeing. The field of using literature in health is a diverse area and as a clinician it can be hard to know where to start.
As starting points, participants in the project identified some of the text below about how people use literature
Burnout
Schwartz Rounds
Inter-Professional Education
The Royal College of Psychiatrists and other helpful websites identify useful resources for mental wellbeing. Several user and advocacy group also identify these. Below we have listed some of the supportive literature (books, poems and essays) identified by our conference participants.
Death and Grief
Anger
Sadness
Depression
Stress
Panic
Mental Health
Anxiety
Mental Illnesses
Burnout
Bipolar Disorder
Cancer
Dyslexia
Stroke
ALS
Schizophrenia
Dementia
Stigma
Health Literacy
Behaving with the Ill
Hospitalization
Resources for Children
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Diseases of Modern Life’s programme of research speaks to many of the most pressing issues of our time, including work place stress and burnout, increases in psychological disorders, and education and mental health in the young. The project’s historically informed and multi-disciplinary approach gave rise to Mind Reading, an ongoing collaboration led by Child and Adolescent psychiatrist Elizabeth Barrett (Children’s University Hospital Temple St and University College Dublin) and literary historian Melissa Dickson (University of Birmingham).
Mind Reading was founded upon a simple question: do clinicians and patients speak the same language, and how might we use literature to bridge the evident gaps? We are interested in how literature might function as a source of comfort or a frame of reference in moments of pain, trauma, and physical and mental illness, in how medical and clinical knowledge might be deployed and refracted through literary worlds, as well as the ways in which literary techniques like textual analysis might be employed as tools to foster understanding between medical learners, healthcare providers, service users, and family members.
Our pilot conference, Mental Health and the Written Word, was held at the beautiful dlr LexIcon Library in Dun Laoghaire, Dublin in March 2017. The full conference programme, with more videos from the day, is available here
Our second conference, The Role of Narrative in Mental Health, was held at the University of Birmingham in June 2018. The full conference programme, with videos from the day, is available here
Our third conference, Adolescence, Literature and Mental Health, was held at St Anne's College, University of Oxford in May 2019. The full conference programme is available here.
Our fourth conference is scheduled to take place at the Royal College of Physicians of Ireland, Kildare Street, Dublin, on Friday, 3rd April 2020