Artistic Licence: Why a book might not save your life

Don’t be fooled by popular wisdom — when it comes to eating disorders, books can be just as harmful as other forms of media, finds Francesca Moll...

It is a truth seemingly universally acknowledged that the mainstream media can have a negative effect on eating disorders. But what about books? According to Dr Emily Troscianko, of Oxford’s Medieval and Modern Languages Faculty, we ignore them at our peril.

Dr Troscianko, whose research spans cognitive studies and German literature, also writes a blog for Psychology Today based on her personal experience with anorexia and the science of eating disorders. She was inspired to bring together the two sides of her research when she realised how little was known about the relationship between eating disorders and reading.

As part of a Knowledge Exchange Fellowship with TORCH (The Oxford Research Centre in the Humanities), she teamed up with BEAT, the UK’s largest eating disorders charity, to find out how these illnesses might affect how people engage with literature, and whether reading could help sufferers adopt more healthy ways of thinking.

Together they came up with a comprehensive survey of over 60 questions, assessing how mood, self-esteem, body image and diet and exercise habits were affected by reading. This was filled out by nearly 900 respondents in varying stages of eating disorder recovery, both from BEAT’s UK volunteer network and via sister charities in the US, Canada, and Australia.

The results proved quite a shock: certain books seemed to make illness worse, and these were the ones that the theory of ‘creative bibliotherapy’ predicts would be most helpful for recovery. It is generally assumed that illness narratives, where the main character goes through the same illness as the reader, would be best at generating insight and a desire to recover.

But Dr Troscianko found that in fact the reverse was true: an overwhelming majority of respondents reported decidedly negative effects on their illness from reading such fiction. Indeed, rather distressingly, it seems that many were aware of the negative effect on their mood that they caused, and sought them out deliberately with the intention of making themselves more ill.

Although these works rarely explicitly supported disordered eating, it seems that the moral was getting lost thanks to the restrictive thinking patterns of the readers. Sufferers ended up getting trapped in an endless ‘positive feedback loop’ where the unhealthy mindset that sent them there in the first place was reinforced by reading the same thing described on the page.

‘It’s clear that people are filtering out the stuff that doesn’t accord with the eating disorder mindset and just seeing the positives, the control, the sense of superiority, all those things that are covered in the early parts of the books before the recovery happens, and not seeing that there’s any critical angle on them,’ says Dr Troscianko.

Although it’s usually glossy magazines and TV shows that are blamed for encouraging disordered eating patterns, it’s clear books can be just as harmful, although in different ways.

‘I wonder whether in a way we’re kind of image-saturated. Skeletal catwalk models are still shocking and off-putting and fascinating to some extent, but I wonder whether encountering a description of such a person in words actually might do something equally problematic, just in a different way.

‘One of the things I get frustrated about is that people tend to assume because it’s literature it must be doing good. And there’s no reason to assume that.’

On the other hand, Dr Troscianko also found that many books had a helpful effect on eating disorders. These varied greatly depending on individual taste, with everything from Harry Potter to Pride and Prejudice being mentioned. What they had in common was that they helped to jolt the respondents out of their established thinking patterns by showing them that something else was possible outside of these confining boundaries, or else simply boosted their mood by providing a much-needed escape.

Rather than a narrow focus on the grim reality of eating disorders, then, therapeutic fiction may need to take a more oblique approach. Dr Troscianko is hopeful about the possibilities of metaphor, extended allegory, or even a science fiction or fantasy setting.

‘Eating disorders, all mental illnesses probably, are so much about getting stuck in very narrow circles of thinking and not being able to break out of them, that anything that breaks into that and just forces you to widen your gaze for a moment and to think differently, even just very temporarily, is powerful.’

Dr Troscianko is keen to emphasise that this survey is just the first step; she hopes to back up the subjective data of this self-reported survey with more in-depth psychological experiments.

‘The trouble is you do a little bit of research and then you find out how much you don’t know. But we’re getting there.’

You can read Dr Troscianko’s blog here, as well as following her latest projects — including developing an app to help eating disorder recovery. Visit the BEAT website here.