by Angus Fletcher, PhD, 2003–2004 Audrey and William H. Helfand Fellow

Did you know that after William Shakespeare lost his son Hamnet, he forged a literary invention that can alleviate grief by acting on the emotional circuitry of our brain’s amygdala? Shakespeare tucked it into Hamlet, from where it made its way into modern literary classics such as Ernest Hemingway’s The Sun Also Rises and Joan Didion’s The Year of Magical Thinking.

Did you know that there are two types of PTSD—and that literature contains therapies for both? The first was devised by Greek playwrights in fifth-century BCE to help military veterans recover from the psychological damage of battle; the second by the modern American cartoonist Alison Bechdel to help survivors of chronic domestic abuse.

And did you know that ancient fairy tales contain an antidote to the mental malady that modern psychiatrists refer to as catastrophizing? Or that the antidote was removed by the 18^th-century French author Charles Perrault when he penned his version of Cinderella—which is why it doesn’t exist in the modern fairy tales of Disney’s magic kingdom?

These remarkable—and even fantastical—claims are backed by empirical research that originated during two summer months that I spent at the New York Academy of Medicine Library back in 2003. I had just completed a PhD on Shakespeare at Yale, but my prior background was neuroscience: devoting four years to studying how brain cells communicated and publishing my findings in decidedly nonliterary venues such as The Journal of Biological Chemistry. And, in fact, my focus on the brain was the main reason I had ventured out of a science lab into a literature seminar. I had discovered that the world’s earliest known work of literary criticism, Aristotle’s Poetics, had hypothesized that literature possessed a psychological—in fact, medical—function: purging trauma via a mysterious mechanism termed catharsis.

Despite my curiosity about these matters, I never found anyone willing to fund my research into literature’s healing properties. Until, that is, I approached the New York Academy of Medicine, which granted me $5,000 to devote to exploring the question: Can literature actually do what Aristotle supposed? Can theater, poems, and novels nurture our mental health and well-being?

In the New York Academy of Medicine Library I began grappling with those questions by focusing on a specific case study: the rebellion launched by a group of early-20^th-century novelists—Charlotte Perkins Gilman and Virginia Woolf among them—against the “rest cure,” a now discredited psychiatric treatment, chiefly prescribed to women, for “neurasthenia,” or what we might call heightened cognitive reactivity.

To help me understand what the rest cure was—and why Gilman and Woolf found it so repugnant—Arlene Shaner and the New York Academy of Medicine’s librarians took me on a tour of the pseudoscientific works of the rest cure’s inventor, Dr. Silas Weir Mitchell, including his eerily titled Fat and blood: an essay on the treatment of certain forms of neurasthenia and hysteria (New York: J. B. Lippincott Co, 1888). From there, I was guided through the Library’s collections to consult a first edition of William James’s Principles of Psychology (New York: Henry Holt, 1890), the textbook that inspired the novelists to replace the rest cure with an alternative literary treatment.

That literary treatment worked by stimulating what James referred to in Principles of Psychology as a “stream of consciousness” whose fluid liquidity gentled the emotional “shocks” of heightened cognitive reactivity.

Prior to Woolf, versions of that stream had been attempted by novelists such as Marcel Proust, Dorothy Richardson, and James Joyce. But while Proust and Richardson had written in a fluid first-person style, and Joyce had written in an atomistic third-person style, Woolf realized that James’s therapy could more effectively be translated into literature by combining Joyce’s third-person with Proust and Richardson’s fluidity. That combination allows our reading mind to flow above a troubled consciousness, observing its ripples without feeling their shock. Consider this passage from Woolf’s 1925 novel Mrs. Dalloway, where the novel’s innovative machinery encourages our thoughts to register the “something awful” while our emotions glide tranquilly past.

What a lark! What a plunge! For so it had always seemed to her, when, with a little squeak of the hinges, which she could hear now, she had burst open the French windows and plunged at Bourton into the open air. How fresh, how calm, stiller than this of course, the air was in the early morning; like the flap of a wave; the kiss of a wave; chill and sharp and yet (for a girl of eighteen as she then was) solemn, feeling as she did, standing there at the open window, that something awful was about to happen; looking at the flowers, at the trees with the smoke winding off them and the rooks rising, falling; standing and looking until Peter Walsh said, ‘Musing among the vegetables?’—was that it?—’I prefer men to cauliflowers’—was that it? He must have said it at breakfast one morning when she had gone out on to the terrace—Peter Walsh. He would be back from India one of these days, June or July, she forgot which, for his letters were awfully dull. . .

The spirit I found in the NYAM Library was as important as the documents I perused there. A physical library in the halls of medicine can seem an old-fashioned thing nowadays, when JAMA pre-publishes its newest articles online and few physicians can spare the time to ensconce themselves in a reading carrel. But I benefited deeply from the reflective experience of having the Library’s physical books, manuscripts, and papers before me as my guide, providing a respite from modern life’s relentless speed and carrying me back to the dwelling places where medicine began: the mind’s curiosity and the heart’s care.

In the many years since, I have gone on to partner with doctors, psychologists, and neuroscientists on collaborative research. Most recently, I have engaged in a three-year longitudinal study with Ohio State’s College of Medicine on how reading novels and memoirs can reduce burnout in medical students. And I have authored dozens of book chapters for university press publishers such as Johns Hopkins, Oxford, and Princeton, and dozens of articles for such scholarly journals as Critical Inquiry, Narrative, and New Literary History on the medical and well-being benefits of literature.

None of this work would have happened without that summer, which became for me, as for the many thousands of seekers who have been given the chance to use the New York Academy of Medicine’s Library, a testament to the power of books. The power age-old but vital as ever. The power to teach, to uplift, and even to heal.

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Angus Fletcher is Professor of Story Science at Ohio State’s Project Narrative. A popular account of his research into literature’s medical and well-being effects, including the rest-cure alternative invented by Virginia Woolf, can be found in Wonderworks: The 25 Most Powerful Inventions in the History of Literature (Simon and Schuster, 2021). This work has been praised by Martin Seligman as “enchanting,” by Dr. Rita Charon as “a tour-de-force,” and by Antonio Damasio as “the perfect counter to our season in hell.”