Are books stronger than drugs?

“Often people spontaneously go to a book : it’s much less intimidating than an appointment with a psychiatrist, and there are no waiting times! “, underlines Laure Lacroix, doctor and author of a thesis on bibliotherapy. Often written by therapists specializing in the issue, these books are sometimes frowned upon by French doctors. As if they could only constitute a rough assumption of responsibility for a real pathology. And yet … A growing number of studies tend to show that the effectiveness of some of these manuals – called self-help in Anglo-Saxon countries and self-treatment books in our country – is real. In particular to respond to psychological and mental disorders, pain and certain addictions …

Advice to be followed to the letter

The proven examples are based on ACT techniques, acceptance and commitment therapy. They are generally constructed in three parts: one where the specialist explains the problem scientifically, another which proposes to evaluate its importance via questionnaires and, finally, exercises of “putting into practice” to experiment and change its usual patterns. . Recently, the study of a university team from Basel (Switzerland) measured the influence of a work on burnout on people stressed in their work. For six weeks, the “guinea pigs” had to advance in their reading and perform the suggested exercises. Results: a clear reduction in their degree of stress. Better yet, three months after the experience, their psychological state was re-evaluated to see if the effects of this writing could be lasting. Here again, the results are encouraging. On average, participants’ level of well-being had increased by 34% while their stress level had fallen by 31%. Their rate of emotional exhaustion (a symptom of burnout) had fallen by 19%, they felt much less depressed, while at the same time we measured a 21% increase in their cognitive flexibility, this ability to “see things differently”. Thanks to their reading, these stressed workers had taken charge in order to effectively face their problem.

Consultations, more up to date?

A good book is enough to heal? For the mildest troubles, perhaps. But “thinking about your change” is not enough. Worse, sometimes reading that you have to change everything in your behavior can be discouraging. Hence the importance, to amplify the effectiveness of these readings, of accompanying them with therapeutic monitoring. General practitioner in Vaucluse, Dr Pierre-André Bonnet sometimes puts a book on his prescriptions. “Before any prescription, I try to make the patient understand how thinking about such and such a question can move the situation forward, he explains. The underlying premise is that the resources necessary for his well-being are already there. present in him, and that a little method and work is enough for it to advance. “ In the most serious cases of depression, one cannot envisage such a treatment, the patients not having the capacities to mobilize their own capacities of (re) action. In addition to a few sensitized generalists, psychotherapists in acceptance and commitment therapy (see box) regularly use this tool as a powerful relay in their work. Its content serves both as a basis for discussion and as an extension of meetings by maintaining motivation. “These books make it possible to play down a situation, recognizes Matthieu Villatte, ACT researcher and psychotherapist in Seattle (Washington State). They are full of testimonies that the reader can relate to in order to progress. “

Today paper, tomorrow screens …

How can the efficiency of these structures be further improved? In the United States, multimedia applications designed as games are already in use. “In the event of depression, play establishes links with the patient’s life and makes him active, explains Matthieu Villatte. He can, for example, give him a mindfulness exercise or give him a meditation. So many objectives to fulfill that make you want to take the next step. “ A more interactive and less formatted model than a therapeutic book. But that also requires follow-up. Anglo-Saxon countries are also developing online consultations. “They allow the therapist to see the patient at home, in a less intimidating context: another asset for the treatment”, insists, enthusiastic, Matthieu Villatte. In France, it is not yet time for the book + application + remote consultation package. But the followers of bibliotherapy closely monitor the progress of their Anglo-Saxon colleagues. Come on, everyone to the library!

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