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How Can People With Brain Injury Access Bibliotherapy?

Why it’s critical to restore reading comprehension after brain injury.

Source: cocoandwifi/Pixabay

Jean-Guy Beauvoir is a thirty-something Inspector in the Sûreté du Québec, once married, loyal to his boss Armand Gamache, shot in the line of duty, and addicted to OxyContin. Most importantly, Beauvoir is a fictional character in Louise Penny’s Chief Inspector Gamache mystery series. His character sounds initially like a cliché: the wounded police officer, heroically refusing therapy, becoming an addict. Except that Penny explores the cliché in a multi-novel story arc, through all her characters' thoughts, emotions, behaviors, and interactions. She creates a seemingly stable character in Beauvoir and then, through novel after novel, unravels him. Through Beauvoir, I enter the mind of an arrogant, paranoid, traumatized addict with a severe case of literal self-centeredness, beloved by Gamache.

Gamache loving Beauvoir as a son juxtaposes my own dislike and begs me to ask why and, in doing so, sparks empathy and understanding of addiction. No non-fiction book can replicate this personalized experience.

Fiction writers lure their readers into the minds of their characters, immerse them in their existences, trigger memories and associations so that readers understand the incomprehensible life experiences they couldn’t in non-fiction reality, and learn about and empathize with what they’d previously judged harshly. Readers also find validation of their own judged experiences, see a different perspective on troubling aspects of their relationships and themselves, learn a new way to cope by watching how a character manages similar challenges, and receive a dose of healing.

As Paula J. Schwanenflugel, Ph.D., and Nancy Flanagan Knapp, Ph.D., wrote here in Bibliotherapy: Using Books to Help and Heal:

“[T]he idea of bibliotherapy has existed from ancient times. The library at Thebes in ancient Greece had written over its door, ‘Healing place of the soul,’ and people have always instinctively recognized the power of stories to not only entertain and inform but also to comfort and guide.”

Today, trained health care professionals conduct bibliotherapy. But avid fiction readers who like complex stories like the Gamache series, written by authors devote spend time and effort to their research in order to create believable characters and events, automatically experience self-bibliotherapy. Reading becomes a place of escape into another world and, as well, a place of learning, by crawling into characters' thoughts, feeling their emotions, and seeing the consequences of their actions. Characters turn into real people in our minds. It’s de-stressing to escape one’s own catastrophic life, and healing to find guidance on how to navigate that catastrophe.

“One can even practice bibliotherapy on oneself, as we suspect many avid readers do, returning to favorite books that they know will lift their spirits when life looks generally grey, or, more urgently, seeking written advice or inspiration to help them face significant life challenges”

Unfortunately, people with brain injury who’ve lost their reading comprehension cannot access bibliotherapy, whether on their own or under a therapist’s guidance. At best, maybe they can in a limited way with active therapy guidance. Once avid readers, some survivors may, after brain injury, be limited to cookie-cutter novels or mass paperbacks written wholly for entertainment. Closed to them are series with complex story arcs like that of Beauvoir, who holds favored-son status but falls into rage, paranoia, PTSD, and addiction, or novels that have many layers of meaning. Such series or novels demand memory, concentration, lateral thinking, ability to infer and predict, and visualizing and verbalizing training.

I’ve written before about the loss of my reading, how that germinated my brain injury grief, how lack of cognitive empathy meant health care professionals didn’t pull out all the stops to find a way to restore it in me—and how I finally was introduced to effective treatments that restored it.

Since brain injury stole it from me for 18 years, and continuing traumatic experiences impeded practicing, I’m still working on restoring my reading comprehension. This year, I’ve been gradually improving so that I can use my mental imagery, solidified through verbalizing, to follow Beauvoir’s complex descent into addiction and paranoia. This, despite the fact that my eReader wouldn’t download books two to six; I read book one and skipped right to book 6.5. But adhering to Lindamood-Bell’s visualizing and verbalizing meant that I could infer and still follow Penny’s detailed, excruciating portrait of a man's transformation from reliable second-in-command to believing his boss had abandoned him near his moment of death and wants to rip away the only valuable thing he has left: OxyContin.

Because Beauvoir is fictional, there’s no need to gloss over annoying aspects of his character to ensure he comes across as empathetic, and no need for the reader to like him. In that way, it mimics brain injury experience.

A year ago, I could not have experienced self-bibliotherapy from reading Penny’s novels, nevermind following the story arc. Prior to 2018, I had given up any hope for even de-stressing through book reading.

Here then is another reason why psychiatrists and psychologists must take reading loss seriously. Reading-comprehension loss cuts a person off from the knowledge economy, from reading’s calming effects, from an important part of themselves, and from self-bibliotherapy. It shrinks a person’s therapy down to what they can afford and what a therapist is willing to provide (and only when they’re available). Because of libraries, book reading—and thus self-bibliotherapy—can be free and accessed any time of the day or night.

It’s long past time to build into brain injury care, including long COVID care, the proper assessment of brain activity and diagnosis of reading difficulties, as well as effective treatments to restore both neurons and reading comprehension. It’s long past time to restore to the catastrophically injured the ability to escape their catastrophe for a little while and, in doing so, find independence in healing.

Copyright ©2022 Shireen Anne Jeejeebhoy