Journal of Psychiatric and Mental Health Nursing, 2015, 22, 287–288
Editorial On reading If you are reading this editorial then I have already achieved something that we academics strive for – to influence practice. Granted, reading this short piece is not going to change anything for people who use mental health services, but I have a more modest aim: to reaffirm the importance and pleasure of reading in the lives of mental health nurses. As nursing students, we were all assigned written material to read: books, articles, research reports, technical and policy papers. In turn, we were asked to produce writing of our own that other people – our teachers – would read, to help determine whether we would be accepted into the profession of mental health nursing. This sort of reading, reading to acquire technical, moral and professional knowledge, requires that we already possess a sufficient level of literacy, developed from the books read to us by our parents and caregivers. There is no pleasure comparable to reading. There may be greater pleasures, but none that take us so easily into other worlds and other lives. The transformation of a series of squiggles on a page into a world that is not present is surely an example of the sublime in everyday life. Much academic writing places the pleasure of reading at risk, so an important part of achieving a balance between our personal and professional lives is to read for pleasure. And such pleasure is available in abundance. Novels, short stories, poetry, plays, comics, newspapers, magazines and online media are all around us. Most of us will have cultivated a habit of reading before embarking on nursing education. Our reading may include blogs and online forums, text messages and posts to social media or it might include full-length novels, biographies, histories and so forth. But in our professional roles, reading is part of our lives. We read case histories, service guidelines, health policy and professional journals. We write clinical notes for others to read. We hope our meaning is clear, but we know that every act of communication is an act of translation, and carries the potential for misunderstanding. We probably take for granted the skill, complexity and privilege of reading. It is simply part of who we are. In my experience, mental health nurses have an affinity for written language. A nurse hunched over a crossword is a much more common sight in a mental health unit than in any other clinical setting. As mental health nurses, we are daily confronted with slipperiness of language as service users relate deeply personal experiences through our major © 2015 John Wiley & Sons Ltd
medium of communication: words. A young woman once struggled to explain her experience of voices that told her to harm herself. Despite their unpleasant message, the voices themselves were not unpleasant. She described them as ‘pretty’. How could I write that in a way that captured her meaning? How would it be read by another nurse or clinician? Reading is not an innate human trait (Wolf 2007). There is no ‘reading centre’ in the brain. Rather, the ability to read depends on distributed networks of neural functions that must work cooperatively for reading to occur. In evolutionary terms, reading is a recently acquired skill, a cultural innovation, a form of instrumentalism even, something that makes it easier to follow a particular way of life. Facility with written language used to be regarded as a hallmark of a ‘civilized’ society, but the step away from oral traditions, and from expressive drawing, carving and dance as primary means of communication brought losses as well as gains. Nevertheless, reading is here to stay. For all its pleasures, reading is not without its problems, even its pathologies. Some people are simply not made to read, either because their brains are not wired for written language, or for some other reason, they prefer other means of exploring the world. Our western cultural regard for reading finds an expression in the pathologizing of reading difficulties as ‘dyslexia’: a normative term that implies a deficit rather than a different way of being in the world. But the disproportionate contribution of ‘dyslexics’ to art, culture and science suggests that it is only the relative rarity of ‘dyslexia’ that allows readers to define it as a pathology. Seen from the perspective of someone who finds written language all but inaccessible, the privileging of language skills and the world view that entails might be seen as an imposition, the sort of domination we challenge and resist in the case of the normative medical model of madness. Pathologies of reading are not limited to those who find reading difficult. Some of the most voracious readers experience ‘reading anxiety’: the worry that one brief life is not enough to read all the Great Literature, let alone keep up to date with the avalanche of new writing. I once read of a literary festival at which notable attendees were asked to confess which Great Books they had never read. I felt better for knowing that former British Labour Leader Tony Benn had never read War and Peace. At a systemic level, 287
Editorial
there are those who for various reasons are denied the benefits of reading. Some people disengage from formal education before they learn to read; others are never offered the opportunity to gain basic literacy skills. Such social exclusion is a recipe for spiritual and social impoverishment and a denial of citizenship. An abundance of literature attests to the relationship between literacy and mental health, but of course, you have to be able to read to access that literature. We should all read with gratitude for the gift of written language while being aware that it is not a gift that is extended to all. Fiction provides some of our most vivid depictions of mental illness. Chekov’s Ward Six is worth a hundred theoretical accounts of institutionalization. It is no doubt informed by Chekov’s experiences as a medical practitioner. Similarly García Márquez’s I Only Came to use the Phone fully evokes the surrender to institutionalism. In such accounts, the pleasure of reading merges with the features of the story so that we enjoy the activity of reading even when the content of the story is harrowing. Fictional treatments have given rise to interest in narrative approaches to the clinical understanding of mental illness: a natural extension of the skill of reading. Narrative approaches challenge the primacy of the clinician as professional author, writing an unauthorized biography, often with a plot based on deficit, illness, failure and powerlessness (Crawford et al. 1995). A recent editorial (Baker 2015) outlined the purpose of the innovative Consumer and Practitioner Narrative section of this journal, which promises greater fidelity to the voices of people with mental illness. Such an innovation is welcome, as the health literature is currently dominated by professional voices, not-
References Baker C. (2015) Narrative in nursing practice, edu-
withstanding worthy and worthwhile efforts of researchers to portray experiences of mental illness. I suggest that to fully succeed the Consumer and Practitioner Narrative section will need to attend to the quality of writing: content alone will not suffice to make for compelling reading. In our professional lives, we are confronted with vast amounts of online and printed material which demands our time, attention and scrutiny. It is not easy to keep abreast of ‘the literature’, and even more difficult to read the additional material that helps inform our views of madness, mental illness and human caring. I have a list of essential fiction. It includes Janet Frame’s autobiography Owls do Cry, and the short stories A Night at the Opera and Gorse is not People (both available online). Everyone has such a list, and no two lists are the same. When it comes to the professional literature, Thomas Main’s The Ailment is high on my list, alongside RD Laing’s The Divided Self. I suspect such lists are like those conversations you have about the best music album ever: they depend on where you were at the time. To death and taxes, we could add that reading is one of the certainties of life, at least for professionals. The former two will catch us out before we have completed the latter. So, we should read both for the pleasure it brings, and in search of new horizons. Horizons are forever receding, but there is much pleasure to be had in the search. A. O’BRIEN RN, BA, MPhil, PhD Senior Lecturer, School of Nursing, University of Auckland, Auckland, New Zealand
Crawford P., Nolan P. & Brown B. (1995) Linguis-
Wolf M. (2007) Proust and the Squid. The
tic entrapment: medico-nursing biographies as
Story and Science of the Reading Brain.
fictions. Journal of Advanced Nursing 22,
HarperCollins, New York.
1141–1148.
cation and research. Journal of Psychiatric and Mental Health Nursing 22, 1–2.
288
© 2015 John Wiley & Sons Ltd
Editorial On reading If you are reading this editorial then I have already achieved something that we academics strive for – to influence practice. Granted, reading this short piece is not going to change anything for people who use mental health services, but I have a more modest aim: to reaffirm the importance and pleasure of reading in the lives of mental health nurses. As nursing students, we were all assigned written material to read: books, articles, research reports, technical and policy papers. In turn, we were asked to produce writing of our own that other people – our teachers – would read, to help determine whether we would be accepted into the profession of mental health nursing. This sort of reading, reading to acquire technical, moral and professional knowledge, requires that we already possess a sufficient level of literacy, developed from the books read to us by our parents and caregivers. There is no pleasure comparable to reading. There may be greater pleasures, but none that take us so easily into other worlds and other lives. The transformation of a series of squiggles on a page into a world that is not present is surely an example of the sublime in everyday life. Much academic writing places the pleasure of reading at risk, so an important part of achieving a balance between our personal and professional lives is to read for pleasure. And such pleasure is available in abundance. Novels, short stories, poetry, plays, comics, newspapers, magazines and online media are all around us. Most of us will have cultivated a habit of reading before embarking on nursing education. Our reading may include blogs and online forums, text messages and posts to social media or it might include full-length novels, biographies, histories and so forth. But in our professional roles, reading is part of our lives. We read case histories, service guidelines, health policy and professional journals. We write clinical notes for others to read. We hope our meaning is clear, but we know that every act of communication is an act of translation, and carries the potential for misunderstanding. We probably take for granted the skill, complexity and privilege of reading. It is simply part of who we are. In my experience, mental health nurses have an affinity for written language. A nurse hunched over a crossword is a much more common sight in a mental health unit than in any other clinical setting. As mental health nurses, we are daily confronted with slipperiness of language as service users relate deeply personal experiences through our major © 2015 John Wiley & Sons Ltd
medium of communication: words. A young woman once struggled to explain her experience of voices that told her to harm herself. Despite their unpleasant message, the voices themselves were not unpleasant. She described them as ‘pretty’. How could I write that in a way that captured her meaning? How would it be read by another nurse or clinician? Reading is not an innate human trait (Wolf 2007). There is no ‘reading centre’ in the brain. Rather, the ability to read depends on distributed networks of neural functions that must work cooperatively for reading to occur. In evolutionary terms, reading is a recently acquired skill, a cultural innovation, a form of instrumentalism even, something that makes it easier to follow a particular way of life. Facility with written language used to be regarded as a hallmark of a ‘civilized’ society, but the step away from oral traditions, and from expressive drawing, carving and dance as primary means of communication brought losses as well as gains. Nevertheless, reading is here to stay. For all its pleasures, reading is not without its problems, even its pathologies. Some people are simply not made to read, either because their brains are not wired for written language, or for some other reason, they prefer other means of exploring the world. Our western cultural regard for reading finds an expression in the pathologizing of reading difficulties as ‘dyslexia’: a normative term that implies a deficit rather than a different way of being in the world. But the disproportionate contribution of ‘dyslexics’ to art, culture and science suggests that it is only the relative rarity of ‘dyslexia’ that allows readers to define it as a pathology. Seen from the perspective of someone who finds written language all but inaccessible, the privileging of language skills and the world view that entails might be seen as an imposition, the sort of domination we challenge and resist in the case of the normative medical model of madness. Pathologies of reading are not limited to those who find reading difficult. Some of the most voracious readers experience ‘reading anxiety’: the worry that one brief life is not enough to read all the Great Literature, let alone keep up to date with the avalanche of new writing. I once read of a literary festival at which notable attendees were asked to confess which Great Books they had never read. I felt better for knowing that former British Labour Leader Tony Benn had never read War and Peace. At a systemic level, 287
Editorial
there are those who for various reasons are denied the benefits of reading. Some people disengage from formal education before they learn to read; others are never offered the opportunity to gain basic literacy skills. Such social exclusion is a recipe for spiritual and social impoverishment and a denial of citizenship. An abundance of literature attests to the relationship between literacy and mental health, but of course, you have to be able to read to access that literature. We should all read with gratitude for the gift of written language while being aware that it is not a gift that is extended to all. Fiction provides some of our most vivid depictions of mental illness. Chekov’s Ward Six is worth a hundred theoretical accounts of institutionalization. It is no doubt informed by Chekov’s experiences as a medical practitioner. Similarly García Márquez’s I Only Came to use the Phone fully evokes the surrender to institutionalism. In such accounts, the pleasure of reading merges with the features of the story so that we enjoy the activity of reading even when the content of the story is harrowing. Fictional treatments have given rise to interest in narrative approaches to the clinical understanding of mental illness: a natural extension of the skill of reading. Narrative approaches challenge the primacy of the clinician as professional author, writing an unauthorized biography, often with a plot based on deficit, illness, failure and powerlessness (Crawford et al. 1995). A recent editorial (Baker 2015) outlined the purpose of the innovative Consumer and Practitioner Narrative section of this journal, which promises greater fidelity to the voices of people with mental illness. Such an innovation is welcome, as the health literature is currently dominated by professional voices, not-
References Baker C. (2015) Narrative in nursing practice, edu-
withstanding worthy and worthwhile efforts of researchers to portray experiences of mental illness. I suggest that to fully succeed the Consumer and Practitioner Narrative section will need to attend to the quality of writing: content alone will not suffice to make for compelling reading. In our professional lives, we are confronted with vast amounts of online and printed material which demands our time, attention and scrutiny. It is not easy to keep abreast of ‘the literature’, and even more difficult to read the additional material that helps inform our views of madness, mental illness and human caring. I have a list of essential fiction. It includes Janet Frame’s autobiography Owls do Cry, and the short stories A Night at the Opera and Gorse is not People (both available online). Everyone has such a list, and no two lists are the same. When it comes to the professional literature, Thomas Main’s The Ailment is high on my list, alongside RD Laing’s The Divided Self. I suspect such lists are like those conversations you have about the best music album ever: they depend on where you were at the time. To death and taxes, we could add that reading is one of the certainties of life, at least for professionals. The former two will catch us out before we have completed the latter. So, we should read both for the pleasure it brings, and in search of new horizons. Horizons are forever receding, but there is much pleasure to be had in the search. A. O’BRIEN RN, BA, MPhil, PhD Senior Lecturer, School of Nursing, University of Auckland, Auckland, New Zealand
Crawford P., Nolan P. & Brown B. (1995) Linguis-
Wolf M. (2007) Proust and the Squid. The
tic entrapment: medico-nursing biographies as
Story and Science of the Reading Brain.
fictions. Journal of Advanced Nursing 22,
HarperCollins, New York.
1141–1148.
cation and research. Journal of Psychiatric and Mental Health Nursing 22, 1–2.
288
© 2015 John Wiley & Sons Ltd
