Novels are the best medicine for psychiatrists

Jun 21 2005

Psychiatrists could improve their clinical skills by putting their feet up with a good novel, rather than burying their noses in academic journals, delegates at the annual conference of The Royal College of Psychiatrists were told today.

Dr Allan (correct) Beveridge, a consultant psychiatrist at Queen Margaret Hospital, Dunfermline, said reading literature could help doctors better understand the "narratives" of their patients. The creation of an Arts and Medicine faculty at Durham University, the publication of a new academic journal Medical Humanities and the proposal to set up an Arts and Psychiatry special interest group at the College, all sprung from the belief that it was beneficial for doctors to be exposed to the arts, said Dr Beveridge.

In the eighteenth century, it was held that a doctor should be a man of culture, well versed in the arts, which would confer wisdom on his clinical practice. Nowadays, doctors prefer to see themselves as scientists and biotechnicians, said Dr Beveridge, and many saw a knowledge of the arts as irrelevant.

However, there were six good reasons in favour of psychiatrists reading literature, Dr Beveridge told delegates. The first was that literature allowed doctors to engage with many more people and "inner worlds" than they could ever hope to do as individuals. Secondly, doctors need a deeper understanding of their patients that took account of their emotional lives; a purely bioscientific model offered a limited view of human beings. Literature offered a richer perspective, said Dr Beveridge.

He cited a study in 1995 which showed that medical students who had a background in humanities and science, rather than science alone, went on to perform better in all areas of practice.

Secondly, reading literature, also helped to develop empathy. "One can see the world from another person's viewpoint," said Dr Beveridge. "This is especially applicable to literary accounts of illness and suffering."

He cited Dostoyevsky's novels, with their rich array of characters with mental disturbances; Iain Crichton Smith's In the Middle of the Wood, in which the writer describes his own breakdown; Sylvia Plath's The Bell Jar, in which she describes her depressive episodes and Evelyn Waugh's The Ordeal of Gilbert Penfold in which he writes about drug-induced hallucinosis.

The third reason was that reading literature could also leads to refined interpretive skills, with the techniques involved in understanding and analysing a novel being applied to understanding a patient's story. Fifthly, ethical dilemmas thrown up by literature could also be used to explore the dilemma facing the psychiatrist in deciding whether a patient is describing a real event or a delusion, said Dr Beveridge. He concluded by saying that a knowledge of the arts could "refocus" the whole of medicine to an understanding of what it is to be fully human.

Dr Beveridge said there was "a growing acknowledgement" of the value of the humanities in medical education and advocated the establishment of a short list of "approved" novels, which should be suggested, rather than compulsory reading. "It will then be left to the individual psychiatrist to decide whether they are worth exploring. A medical culture that takes a positive approach to the humanities will greatly encourage such explorations."