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September 18, 2021

“Fictional Therapy”: Healing through Trauma Stories.


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“What you bring back is a story. Your story. You can be the villain, victim, sidekick, or hero. It’s up to you.” ~ Lori-Beth, The Fictional Therapist

My story: from air force to Austen.

As far back as I can remember, I adored books—fairy tales, nursery rhymes, thrillers, romances, and made-up stories from my late father. I recall laughing out loud to Sue Townsend’s The Secret Diary of Adrian Mole, Aged 13 ¾ while listening to “Take That” and “Boyzone” on my Walkman.

At school, I loved English and drama, but I easily put off my aspirations to be a writer and an actress after being advised that it was “highly unlikely.”

I finished school just shy of my 16th birthday and didn’t really have any idea what I wanted to do. I took on work and different college courses for six months before joining the Royal Air Force (RAF) as a medic. Joining the RAF changed my trajectory; it introduced me to people and places I would not have encountered in my small English seaside town. It enriched my story.

I was also far too young to join; I was basically still a child—a child with a weapon by day and way too much alcohol by night.

I essentially went through my teenage years, including the usual angst and poor life decisions (a truckload of them…) in front of cohorts of military personnel instead of parents and peers. Though, one thing that did remain static was my love of literature.

Now, I thank books for my vocabulary as I’m sure leaving school at 15 left me somewhat less articulate than if I’d remained in full-time education like many of my friends.

I read everywhere—on courses, on trains, and on military deployments. When I was working on rotary aircraft as a medic in Iraq, I devoured books in my downtime, which was a brief reverie from the harsh realities of war.

After witnessing, firsthand, the psychological consequences of war, I left the RAF after nine years to train as a mental health nurse.

Despite being occupied with studies, children, and part-time work, I continued to read. There was always time for a book. While working as a mental health nurse, I found solace in literature. Literature facilitated beautiful, impromptu, fictitious vacations, and it prevented me from replaying the trauma, deeply rooted in my memory, during my working day.

I also found books and movies to be a great icebreaker with patients. Instead of making small talk about the weather as we worked together to form a therapeutic alliance, we discussed books, TV series, and films. I would often recommend literary pieces, and reflective discussions on the characters and themes became commonplace.

What I believed to be just a hobby soon became a therapeutic intervention. I noticed that patients were taking profound life lessons from books, and it was also acting as a diversion from their worries. They found hope in the stories of others, and it was improving their own life chapters. However, it would be years later that I would actually start using books and movies as a standalone intervention.

Fast forward to 2018, and I am sat on a packed aircraft with my husband, two sons, and a bagful of books with a one-way ticket to Brisbane, Australia.

The long tedious flight turned out to be the easiest part of emigrating. Perhaps, my military lifestyle of moving every few years caused me to underestimate the disruption of the move on myself and my family.

Adapting to life “down under” was tough. I quickly discovered that mental health nursing is different in Australia. Working as a mental health nurse in Australia required no qualifications in mental health and entailed lots of general nursing skills—skills I did not have.

I felt my degree in mental health nursing was essentially redundant. I could work in a ward, but it was completely different from the engaging therapeutic one-on-one and group work to which I had become accustomed and thrived on in the United Kingdom.

These circumstances forced me out of my comfort zone, and I ventured into teaching. It was through my work with student nurses that I developed a fictional therapy program. I would prescribe stories or films (Fiction-on-Prescription) to the student nurses and ask them to watch or read mindfully and write mental state assessments on the characters prior to presenting them back to the group.

This achieved two main objectives.

Firstly, it allowed them space to reflect and relax, as the placements on the ward—on top of their studies—were often taxing. Hearing trauma stories in mental health requires clinicians to be vigilant in their own self-care practices. To try and stay mentally healthy themselves, this activity gave them downtime to retreat and repair. It also allowed them to develop their critical thinking skills and clinical judgment.

The discussions were fun and filled with opportunities for the students to learn from each other and challenge one another’s assessments. I also enjoyed hearing how they’d describe characters as played by superstars like Leonardo DiCaprio.

These sessions received excellent feedback, and after two and a half years, I made the decision to start my own “Bibliotherapy” and “Fictional Therapy” practice.

My husband thought I’d been reading too much fiction and did try to talk me up from the rabbit hole as he hadn’t heard of bibliotherapy before.

I soon learned that he was in the majority.

A brief history of bibliotherapy.

Bibliotherapy (also referred to as book and poetry therapy or therapeutic storytelling) is a creative arts modality that involves engaging with books in their many forms with the purpose of healing. It allows the reader to identify with subject matters, characters, narratives, and context and explore their feelings in relation to this therapeutic content.

Bibliotherapy is actually an old concept and can be traced back to ancient Greek times. It has been widely used with battle-injured personnel, undergoing treatment and end-of-life care during world wars. Its use has been praised in many settings, including hospitals, schools, and prisons.

Fictional therapy.

Fictional therapy is a multi-faceted therapeutic intervention that was born through my personal and professional practice.

It incorporates principles from a selection of therapeutic interventions that I have found to be useful over the past 22 years and uses the unique and powerful medium of fiction. It entails engaging with the prescribed book or movie and identifying with the characters and themes.

From here, the therapeutic process starts. We work together as a duo or in groups to discuss the lessons from the material and apply these lessons to our own reality. It’s a lovely way to tackle tough topics, ingrained schemas, habits, and beliefs without being overly confronting.

We tackle our own issues and concerns through the medium of fiction.

Book, film, poetry, art, and writing therapy.

We all know that little grows in the comfort zone, and we can easily get stuck doing the same old things. Connecting to something new can create positive outcomes all on its own.

I adore watching people—who have told me they are “useless” at drawing or “rubbish” at poetry—demonstrate that they are actually rather brilliant.

I believe now, more than ever, that we need hope—hope for a compelling future and a stable and healthy present.

Books and movies are my therapeutic modalities, and they are readily available to most of us. Now seems to be the ideal opportunity to take everyday activities and engage in them in a mindful and meaningful manner so we can reap the therapeutic benefits.

As the COVID-19 pandemic continues to affect all of us, we can learn, escape, and grow through literature and film. We probably have the ideal therapist sitting on our bookshelf, hidden beneath a pretty cover and fancy title.

My overall mission at Alice and The Alchemist is to help curate happier and healthier life chapters through the beautiful medium of story.

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