Your Health Checkup: Reading for Mental Health

Literary fiction may help us deal with complex social relationships and develop empathy for others.

Boy reading a book on a sofa

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“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

Order Dr. Zipes’ books, Ari’s Spoon, a new novel, as well as Bear’s Promise and Damn the Naysayers, A Doctor’s Memoir. Check out his website at


In these columns I’ve stressed the importance of exercise, diet, proper medications, and maintaining control of blood pressure, cholesterol, and healthy habits. Physical health also includes mental health as an integral component.

Experts in this area recommend a variety of approaches, including relaxation, yoga, and meditation, to deal with negative emotions such as anxiety, depression, stress, anger, and grief.

I’d like to suggest another — often overlooked — path to mental health: reading…particularly literary fiction.

In today’s climate, perhaps more than at any other time in recent history, it is important to understand other people, their state of mind, their emotions, and their points of view. The ability to do so, part of the evolution of humankind, is known as the Theory of Mind (ToM); it allows us to deal with complex social relationships and develop empathy for others. Failure to do so — anti-social behavior — is a major cause of interpersonal problems and the rupture of relations between individuals, groups, and countries.

As a “born again novelist,” (Ari’s Spoon), what caught my attention recently is a study published several years ago in one of the premier scientific journals that helped establish a link between ToM and literary fiction. Reading fiction, particularly literary fiction — not the usual plot-driven spy/horror/detective thrillers of popular fiction — can increase feelings of empathy, expand our knowledge of others’ lives and cultures, and give us the ability to recognize ourselves in other people. Literary fiction is introspective and character-driven, so that any action in the story affects the main character and vice versa, and understanding this impact is the whole point of telling the story. This enables us to understand the human condition and difficult social or political issues.

Some early examples include Cervantes’ The Ingenious Gentleman Don Quixote of La Mancha in which the hero attempts to act with courage and integrity; Dickens’s A Christmas Carol, which recounts the greed of Ebenezer Scrooge and his redemption; and Stowe’s Uncle Tom’s Cabin, which focuses on the evils of slavery. More recent examples include Morrison’s Beloved, another account about the traumas of slavery; Wingate’s Before We Were Yours, which presents the suffering inflicted on defenseless families; and Cummins’s American Dirt, which details the lives of immigrants fleeing terror.

In each example, the author invites the readers to almost become a co-author as they interact with the lives of the characters. While readers subjectively interpret the emotions and thoughts of the characters, they consider their own feelings, thus promoting ToM.

To determine the impact of reading literary fiction, investigators used a standardized test to measure ToM. They tested the connection between ToM and reading nonfiction, popular fiction, or nothing at all versus reading literary fiction written by award-winning writers.

They found that ToM scores were significantly higher after reading literary fiction than reading popular fiction or non-reading. The authors propose that literary fiction prompts readers to take an active “writerly role to form representations of characters’ subjective states,” enabling literary fiction to recruit ToM. That was one of my goals in writing Ari’s Spoon.

While these conclusions are interesting and on an intuitive level make sense, the issues are quite complex, and there are likely many consequences to reading any kind of fiction or nonfiction that may be independent of ToM. Nevertheless, I’d like to suggest that reading, particularly literary fiction, can promote feelings of empathy, enhance social welfare, and improve interpersonal relations. But for each of us, whatever type of storytelling it takes, understanding the feelings of others is sorely needed in today’s world.

Featured image: Shutterstock

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