Skip to main content

Verified by Psychology Today


"Breaking Through" With Books

A look at a transformative clinical reading initiative from The Reader.

Key points

  • The process of Shared Reading can affect psychological and cognitive transformations.
  • The report looks at language, mobility of the mind, and concepts of time as evidence of change.
  • A valuable aspect of Shared Reading is its role in fostering connections and recovery.

For an introductory discussion on clinical bibliotherapy and different models in practice, please see "Prescribing Prose and Poetry."

In the bustling boroughs of south/south-east London, amidst the vibrant tapestry of life, a remarkable endeavor was quietly unfolding. It was a literary journey—a voyage of the mind and a shared experience that transcended age, background, and circumstance.

The stage was set for a profound exploration of human connection, the intricacies of thought, and the transformative power of words. This journey, as unveiled in the extensive report "What Literature Can Do" from the University of Liverpool's Centre for Research into Reading, Literature, and Society, delves into the heart of The Reader’s Shared Reading program.

Imagine a diverse ensemble of individuals, each with their own story to tell: adult members seeking solace in public libraries, older adults residing in extra-care residential units or gathering in local community groups, children in the bloom of youth attending a state-funded primary school, those navigating the labyrinth of mental health challenges, and those on the path to recovery from addiction. These five distinct groups from the boroughs of London embarked on a 24-week experience of Shared Reading, delving into the pages of literature to discover what lies within and beyond.

What unfolded within this literary cocoon was nothing short of remarkable. The report shines a radiant light on the intricate psychological and cognitive processes that underpin The Reader's Shared Reading Model.

What Does The Reader's Program Look Like?

The "What Literature Can Do" report explains that under the Shared Reading model, a small group (2-12 people) meets with a trained group leader to read aloud, in real time, a wide range of pieces of literature: poems, short stories, novels. People, in addition to the leader, can volunteer to read and the reading naturally pauses when individuals share their reactions or thoughts with the group.

Prasanna Kumar / Unsplash
Source: Prasanna Kumar / Unsplash

The report sheds light on the psychological and cognitive processes involved in the Reader's Shared Reading Model. The Reader presents a cycle called “Core Theory of Change":

  • In the beginning, the individual may be "stuck" in their emotions, thought patterns, or behavior.
  • The person first “Gets into the Literature.” In this first stage, they are “feeling safe,” which means they get curious and “trust enough to take the next step” (17).
  • When they "Stay in the Literature," they next begin to experience “liveness,” which can manifest in “feel[ing] surprise/excitement/shock” or feeling "real responses and challenge” (17).
  • By staying in the literature, they experience over time “growing” or "Breaking Through": They may have increased openness to the experience and possibilities and/or increased attention, concentration, and willingness (17). This is where The Reader identifies, in the cycle, the hard outcomes of Shared Reading aloud—e.g., “improved well-being for people at risk of isolation or mental health problems” (17).
  • The final stage in the cycle is “Doing,” in which group members can become “more open to other experiences/risks,” can “realise/rediscover self,” and/or can “feel connected to human beings” (17).

“Getting into it,” “Staying In It,” and Feelings: The "getting into a poem" and "staying in it” stages are dependent on individuals establishing a deep and emotionally immersive connection with the text (20). Emotions take on a crucial role as messengers of internal psychological realities that should not be ignored for the sake of well-being and personal growth (19). Arthur, a participant, emphasizes that when engaging with literature, individuals actively participate in the emotional landscape—imagining, expressing, reading aloud, performing, and genuinely feeling the emotions portrayed (19).

“Staying In It” and Specific Versus General Memory: The authors highlight the distinction between specific and over-general memory, emphasizing that difficulty in accessing specific episodic memories is linked to depressive tendencies (12). Depression often leads to a fixation on over-general and categorical ruminations, devoid of life's specific examples or exceptions, qualitative distinctiveness, or elaboration. This rigid pattern can result in negative reinforcement. The report suggests that Shared Reading might serve as a more spontaneous method to enhance access to specific autobiographical memories (12). By engaging with literature, individuals participating in Shared Reading are encouraged to explore narratives that offer qualitative distinctiveness and exceptions to their own life stories, potentially breaking the cycle of negative re-enforcement and rigid thought patterns associated with depression (12). This process may facilitate personal growth and emotional well-being by providing a space for participants to connect with their own experiences and those of others in a more dynamic and healing way.

“Breaking Through” and Language: Language choices serve as indicators of the transformative process readers undergo when they navigate the journey of familiarizing themselves with their emotions and the challenges of articulation. It is imperative for readers to transition from raw emotions to the ability to convey those emotions through coherent thought, a transition crucial for mental well-being and personal growth, according to psychoanalyst W.R. Bion (43). This shift involves extracting thoughts embedded within emotions while preserving their emotional depth, forming the foundation for positive change. This breakthrough in the reading process often manifests through linguistic changes such as the use of metaphors, concepts, and similes that bridge the familiar and unfamiliar (“like,” “almost like,” “kind of,” “sort of”) facilitating a creative reconnection with personal experiences and thoughts, ultimately fostering connections with others (26). Dr. Koleva suggests that this process, potentially the opposite of de-familiarization, may lead individuals to a deeper understanding of their experiences and closer connections with others (26). The concept of "hangings," moments when speakers leave thoughts incomplete, signifies a point of emptiness in the face of the unknown, marking the inception of the process of articulating feelings and thoughts (26).

“Breaking Through” and Mobility of the Mind: The concept of "mobility of mind" entails an expansion of empathy and the ability to imagine the perspectives of others (31). This is reflected in the way readers shift their pronouns, moving from third person to first person and back as they engage with characters and navigate their relationships with the text and others. In a group context, this represents metacognition, the capacity to simultaneously consider one's own viewpoint from both an internal and external perspective. In essence, reading literature fosters the development of flexible and intricate mental perspectives concerning both oneself and others, enhancing the evolved capacity for metacognition, allowing individuals to view themselves as if they were others without complete separation, as described by psychologists (35).

“Breaking Through” and Concepts of Time: The concept of "movements of time" involves diverse patterns of mental structure, including fragments, mosaics, and quilting. The report suggests that literature not only permits but also fosters such responses, even among readers who face no barriers to immediate comprehension or expression. This engagement with literature triggers the retrieval of autobiographical memories and promotes non-linear modes of thinking, understanding, and intuition. Literature, in particular, addresses the emotional and temporal disorientation often experienced in response to traumatic events or unforeseen conditions that were previously considered unlikely or impossible (38-39).

Physio-Psychological Considerations: CRILS conducted fMRI brain-imaging experiments with 24 participants reading 16 texts in a scanner. Half of the texts developed linearly, while the others had a surprising fourth line, leading to an unexpected overall meaning. Both poetic and control "a-ha" moments increased activity in the inferior temporal gyrus and hippocampus. Unique to poetic "a-ha" moments was left caudate nucleus activation, indicating recognition of prediction errors and a rewarding sensation. Hypotheses suggest that encouraging "a-ha" moments through literature, especially as they relate to the left caudate nucleus, could help individuals with rigid beliefs like depression. Engagement with poetry could enhance mental flexibility by challenging fixed expectations and promoting rewarding meaning reappraisal (45).

Hush Naidoo Jade Photography / Unsplash
Source: Hush Naidoo Jade Photography / Unsplash

What Were the Ultimate Conclusions?

In their qualitative analysis, the study's key findings highlight several valuable aspects of Shared Reading:

  1. First, Shared Reading can foster a more personal world, enhancing individual immersion and social bonding.
  2. Additionally, even participants who are not experienced readers can exhibit profound cognitive and imaginative understanding through deep creative reading.
  3. Linguistic analysis of changes in syntax and vocabulary suggests readers breaking through to a deeper sense of meaningfulness.
  4. Inarticulacy and the struggle for articulation are valued experiences that can lead to a profound sense of empowerment.
  5. Shared Reading awakens capabilities related to emotion, memory, and core self, contributing to recovery.
  6. Shared Reading functions as therapy without the structure of formal therapeutic programs, offering participants a sense of freedom and honesty.
  7. Finally, the emotional and imaginative power of literature, skillfully facilitated by group leaders, strengthens the sense of community within the group (56-57).

In the end, the study's qualitative analysis uncovers a treasure trove of insights. Shared Reading, it reveals, can forge personal worlds, ignite cognitive and imaginative understanding, transform language, empower articulacy, awaken the core self, and serve as an unconventional form of therapy. Above all, it weaves a tapestry of emotional and imaginative power, fostering a sense of community that transcends the boundaries of age, background, and circumstance.


Davis, Phillip, et al. "What Literature Can Do." Centre for Research into Reading, Literature and Society, University of Liverpool,…. Accessed 22 Sept. 2023.

More from Melissa Rampelli Ph.D.
More from Psychology Today