1. Learning from Literature:
An Evaluation of Ideas Regarding Mental Illness Seen in Young Adult Speculative Literature
Amanda Sanders

3. Table of Contents
1. Introduction………………………………….………………………………………….5
2. Mental illness does not need to define someone's life. Everyone's experiences are
different…………………………………………………………………………………29
3. The Role of Friendship…………………………………………………………………57
4. The Danger of Recklessness……………………………………………………………67
5. Labeling and Its Effects…………………………………………………………………71
6. Treatment and Decision-Making………………………………….………….…………79
7. Conclusions…………………………………………………………………….……….97
Works Cited………………………………………………………………………………..125
Appendix A: Breakdown of Content in Amazon.com Mockingjay Reviews………………139
Appendix B: Partial List of YA Speculative Books Dealing with Mental Illness-like
Conditions……………………………………………………………………………..145
Appendix C: My Sample Author's Note for New Moon…………………………………...149

5. I. Introduction
As people read stories, fictional ideas have the potential to become real. For example, let
us examine a group of four adolescent girls at lunch. Between school, crushes, and last night's
TV shows, they touch on the current “it” novel, Vampires are a Girl's Best Friend. Three of the
girls, Laura, Maddy, and Veronica, have completed it, while the fourth, Mary, is still reading it.
As they talk about the book, they show how they are interacting with the novel. The plot
involves two vampires of teenage appearance, Bob and Charles, fighting over a human, Ellie.
She becomes increasingly depressed over her circumstances throughout the novel as Bob and
Charles fight to the death over her. In the group of readers, Veronica is the clear leader, and the
others take their cues from her. She believes that Charles is clearly the right choice for Ellie, and
Mary and Laura agree. Since she holds a minority opinion, Maddy has been led to believe her
opinion is invalid. This is frustrating, but generally harmless. The group’s opinions regarding
Ellie's depression are more consequential. Since the issue at hand is Ellie's mental health and
identity, opinions of these fictional characters can be more serious. The group believes Ellie's
depression is pathetic, and she should be able to snap out of it. Maddy, however, has been taking
an antidepressant for anxiety. Due to the way the group feels about Ellie, Maddy believes her
friends would consider her to be pathetic if they were to find out.
This invented example suggests implications of the way readers interact with novels and
how these ideas can play a role in the world outside of the page characters who display
symptoms of mental illness. A recent survey of young adult literature found that a quarter of
those books deal with issues of mental illness (Koss and Teale 567). While the characters are
fictional, they may, in fact, be young readers’ role models regarding mental illness. Nearly half

6. of teens in the United States have a mental illness, and for about a quarter, this is severe enough
to affect their lives (Merikangas et al). Despite this, many people are still unwilling to interact
fully with individuals they perceive to have a mental illness, viewing these individuals as
dangerous (Pescosolido et al 1323-4). Adolescents, however, have popular fictional characters
with mental illness who can be used as starting points for discussion. It is therefore important to
examine what exactly these books are saying about mental illness. Positive messages can help
people deal with mental illnesses, while negative ones can reinforce stigma or teach dangerous
lessons. These can reinforce what it means to have a mental illness for readers. While I am
looking at fictional characters as opposed to real people, this reinforcement has been seen in how
people interact with mental illness in literature. In a study of published memoirs and
autobiographies dealing with depression, Westerbeek and Mutsaers found that narrative can
allow people to navigate and understand what it is like to live with depression, allowing for the
creation of empowering metaphors (48). Such books can serve a similar role for people both with
and without mental illness.
In this work, I will focus specifically on three series of young adult speculative literature
that are popular favorites: Stephenie Meyer's The Twilight Saga; Richelle Mead's Vampire
Academy, and Suzanne Collins’s The Hunger Games. I examine how these novels depict mental
illness and build upon this to show how the fictional ideas correspond to real world concepts and
how readers perceive these characters. While these books are fiction, as opposed to memoir, they
still present stories of mental illness. This allows readers to likewise navigate these topics. First,
however, I must establish some of the basic concepts that define this project.
Young Adult Speculative Fiction
The works I focus on are part of the specific subset of literature at the intersection of

7. Young Adult fiction (commonly referred to as YA) and speculative fiction. YA is literature that
is geared towards teens. There is no set definition of what this age group is, but using the
broadest limits it is the range from age twelve to nineteen (Mayer; Koss and Teale 563). This
does not mean that younger or older readers are not reading these books, but this is the age range
that these books are specifically aimed and marketed to.
The other major genre is speculative fiction. This is a catchall term referring to all aspects
of science-fiction and fantasy literature (The Speculative Literature Foundation). By combining
these two genres, I am looking at a very small subset of literature, science-fiction and fantasy
stories written for teens. This only accounts for roughly fifteen percent of the books within the
YA genre as a whole (Koss and Teale 566).
While these books may account for only a small portion of books as a whole, they have
been extremely popular in recent years. The best-selling book series of all time on Amazon.com
is Suzanne Collins’s The Hunger Games, overtaking J.K. Rowling's Harry Potter books, another
series of speculative works for young people (Chaudhuri). Although teens comprise the specific
market for YA literature, they are not the only ones reading these books. A recent poll on
National Public Radio (NPR) asked people to vote for their one hundred favorite books of YA
literature. While organizers did not define the meaning of “best,” these books should be
considered to be a representative sample of fan favorites. The poll received a record number of
75,220 votes exceeding the previous record of 60,000 votes for science-fiction and fantasy books
(Russell; Neal). As NPR listeners comprise a larger range of ages than the teenage years to
which YA books are specifically marketed, we can assume that YA literature is popular with
older, and possibly younger, readers as well. Since NPR’s poll on speculative fiction received the
second highest number of votes, these two genres can be considered two of the most popular

8. genres of literature with those who responded to these polls.
To explain this popularity, one needs to look at why people are reading these books.
Popular YA fantasy author Tamora Pierce wrote a piece in which she approaches the question of
why people read these books (50). She describes speculative literature as the genre in which
anything can happen and there is a place for anything (Pierce 50). This specific subgenre is a
“literature of empowerment” where anyone can succeed (Pierce 51). Further, these books can be
used in an escapist manner. For readers for whom reality is overwhelming, these books can be
used as a way to get away and explore different worlds and ideas (Pierce 51). Specifically, she
writes, “Fantasy creates hope and optimism in readers. It is the pure stuff of wonder, the kind
that carries over into everyday life and colors the way readers perceive things around them”
(Pierce 51). English professor Robert Crossley expands upon this idea. He believes that as a
reader reads fantasy, they come out with a more careful understanding of the familiar. This new
knowledge and understanding can work to teach readers lessons about their world (Crossley
288). With these ideas, Pierce and Crossley establish that although the events in a speculative
novel may not all be able to happen in the reader's world, the author's ideas are not trapped
within the confines of the page.
While many people have been obviously embracing these books, the acceptance of YA
literature has not been complete. In 2011, The Wall Street Journal published a critique of the
current state of young adult literature. The article quotes one mother as saying, “It was all
vampires and suicide and self-mutilation, this dark, dark stuff” (Gurdon). Further, says journalist
Megan Cox Gurdon, “Pathologies that went undescribed in print 40 years ago, that were still
only sparingly outlined a generation ago, are now spelled out in stomach-clenching detail”
(Gurdon). Gurdon specifically uses the term “pathologies.” This implies that these books

9. describe abnormal conditions that need to be classified and treated. The tone with which Gurdon
describes these “pathologies” suggests that these are something which should not be described
with the level of “stomach-clenching detail” authors used. She is not clear on whether or not she
believes they should be discussed with fewer details or not at all; Gurdon may be wistful for the
time forty years when these were not discussed at all.
While Gurdon concludes the article by saying that publishers will produce what sells, and
no parent is required to buy a book for their child, she states that at least for younger teens most
current young adult literature is inappropriate. She says the inclusion of topics which result in a
PG-13 or R rating for a movie are not appropriate in this literature marketed for young people, as
these books can shape a reader's interests (Gurdon). She is not alone in feeling this way. One
Amazon.com reviewer of Mockingjay mirrored these thoughts when suggesting that the movie
would be rated R if it were made exactly like the book believing that this made the book too dark
and violent (Allie).1
Perhaps this problem comes from the labeling of the genre as young adult as opposed to
teen fiction. When the readers are not being called children, but young adults, then the inclusion
of adult themes makes logical sense. Gurdon herself even provides two lists of recommended
books that she considers to be appropriate, one for “young men” and one for “young women”
(Gurdon). In this way, Gurdon is accepting the use of labels which imply that readers are more
mature than they actually are.
In fact, Gurdon may not be entirely accurate in how she depicts the pathologies in YA
literature. Koss and Teale’s survey of young adult literature suggests that such books may be
outliers rather than the norm. They found that although the books dealt with dark topics, they
were more about fitting in and navigating life than wallowing in the grittier topics of sex and

10. drugs (567-8). This is not to say that these books do not deal with less than ideal aspects of life,
such as mental illness, but that Gurdon’s critique goes too far in its assessment that YA literature
is so deeply focused on the negative aspects of life. While books may include such themes, they
are not necessarily the central focus of the story. With one quarter of teens having diagnosable
mental illnesses that affect their lives, plots involving mental illness are not a huge leap from
what is typical. When these individuals are able to read that although the protagonist's life is not
perfect he or she is able to live a normal, even happy, life, the reader may be able to realize that
they can as well. Finally, when a reader likes a character, even if that character displays
symptoms of a mental illness, then that reader may learn to be more accepting of mental illness
in themselves or their friends.
Specific Books I Have Selected
Stephenie Meyer's New Moon, Richelle Mead's Vampire Academy, and Suzanne Collins’s
The Hunger Games series differ greatly, but they also have much in common. These works of
YA Speculative literature are popular, have a homodiegetic narrator (a narrator who is a part of
the storyworld [Abbott 75]), and deal with what readers might identify as mental illness. Since
2005, the series these books are part of have been appearing on The New York Times best seller
lists. In addition, these series came in twenty-seventh, thirty-ninth, and second respectively on
NPR’s list, showing that these books have remained favorites over time (Russell).2 Finally, the
use of a homodiegetic narrator allows readers into the thoughts and minds of the narrators. This
provides a specific viewpoint taking readers into the narrators' subjective experiences. In the
books I selected, these experiences are either identified as mental illness within the text or are
something that readers identify as mental illness. Thus, the ideas presented by Meyer, Mead, and
Collins are what many people are learning when it comes to living with, treating, and accepting

11. others with mental illness.
Stephenie Meyer's The Twilight Saga
Stephenie Meyer’s first novel, Twilight, was published in 2005 and was followed by New
Moon. In this novel, Bella, the narrator, is represented as experiencing what readers interpret as a
depressive episode, including psychotic symptoms, in New Moon. This episode is largely
triggered by the loss of her boyfriend, Edward. New Moon is a highly reinforced allusion to
William Shakespeare's Romeo and Juliet, and Bella considers her life to be forfeit after Edward
leaves. She metaphorically becomes one of the living dead, a zombie, and it is only the presence
of a friend, Jacob, that helps her regain the living. In addition, Bella’s depressive episode has
some of the most serious symptoms many young readers are exposed to in literature. While Bella
never attempts suicide, Bella is frequently a danger to herself not realizing her actions could
result in her death until it is too late and not caring after she makes this realization
Richelle Mead's Vampire Academy
Richelle Mead’s Vampire Academy also deals with issues of depression, but readers are
given a different perspective. In Vampire Academy, the narrator is Rose Hathaway, whose best
friend is Lissa Dragomir. It is revealed throughout the books that Lissa has a special kind of
magic called “spirit” that has allowed her to bring Rose back from the brink of death. This action
forged a spirit bond between the two which allows Rose to go into Lissa’s mind where she has
access to what Lissa is thinking and feeling. A side effect of Lissa’s spirit magic is a level of
anxiety and depression that has led Lissa to practice self-mutilative behaviors, especially cutting.
While Mead inserts other characters who have dealt with the similar situations (including a
saint), the story focalizes on Rose and her relationship with Lissa. The shifting focalization from

12. Rose to Lissa while retaining Rose as narrator allows Mead to do something unique. She gives
readers multiple perspectives from both inside and outside the depression. As a result of this
construction, readers can gain an understanding of depression and how it plays out in themselves,
their friends, and society as a whole.
Suzanne Collins’s The Hunger Games
Suzanne Collins’s The Hunger Games trilogy, and in particular the conclusion
Mockingjay, can be viewed as a narrative of the psychological effects of trauma and unjust
realities set in a futuristic dystopia. Readers not only get to experience how the narrator, Katniss,
becomes “mentally disoriented” in response to traumatic experiences, in a response readers find
similar to the real world diagnosis of post-traumatic stress disorder (PTSD), but also get to see
how she and others perceive everything from depression to alcohol dependence to a form of
mind control known as “hijacking.” In fact, nearly everyone within the novels’ society displays
some type of stress reaction. While The Hunger Games may be set in a very different world from
the one readers live in, there are recognizable parallels (such as poverty, hunger, and absent
parents), and readers are exposed to a number of different mental illnesses.
Other Sources of Data
Although I will show that readers seem to be accepting of the ideas seen in these books,
this does not mean the ideas presented in the novels are true to life. To establish the veracity or
lack thereof of these ideas, I look outside the literature to related research. Ultimately, the data
generally shows the books are presenting ideas which hold true outside the storyworld.
The first type of real world information I use is social science research. As an overall area
of study, the social sciences seek to apply the concepts of the natural sciences to the human

13. experience (Gordon 17). The particular areas of interest to my study is the experiences of
individuals with mental illness diagnoses as well as their friends and family members. I therefore
began by exploring the studies that examined this areas. I predominantly look at qualitative data
because it is easy to compare the human stories to the fictional narratives. While I began by
examining the general experience of individuals, as I selected more concentrated areas of the
novels to explore, I likewise selected more specific and theoretical social science articles if I
believed they were necessary to show the novel is applicable to the real world in which readers
live.
One specific area where I believe that specialized knowledge is necessary to link the
fictional ideas to the real world is in my discussion of treatment decisions. The books I have
chosen and the readers who have written about them, also engage with concepts from bioethics
such as decision-making capacity, consent, and assent. I will discuss these concepts and the
practice of assessing, defining and utilizing them with adolescents as they pertain to the texts I
have chosen. The theoretical foundation of these concepts is respect for autonomy which has
been written about by many, but most notably in a classic textbook of biomedical ethics written
by Beauchamp and Childress. In theory, autonomy encompasses “self-governance, liberty rights,
privacy, individual choice, freedom of the will, causing one’s behavior, and being one’s own
person” (Beauchamp and Childress 120). Someone who has autonomy is capable of making their
own decisions: A person without autonomy either cannot make their own decisions or is
controlled by others (Beauchamp and Childress 121). Within this work, I explore the intersection
of two groups, adolescents and individuals with mental illnesses, in which one may have
diminished capacity (Elliot 454).

14. Analyzing Fan Behavior
Throughout this work, I examine the way that fans write about and interact with these
works online. I previously stated that I use the data from published social studies, but in
analyzing the behavior of fans, I perform a kind of social science research of my own using a
selection of articles, reviews, and discussions as a qualitative data set. I borrow the idea that by
examining a particular set of behavior insight can be gained into the overall human experience.
Particularly, through examining the way that readers post online, I draw conclusions about the
way these readers are learning about the topic as a whole. I, however, perform this argument as
another source of data to support the ideas found in the literature and link them back to the real
world. This analysis is not intended to be comprehensive, but rather, it is a rudimentary overview
that explores how fan behavior matches with the ideas seen within the other data.
The Expressed Interest of Wanting to Be a Character
Because of the popularity of these novels, there is a visible fan following. This is not a bad
thing, and many fans simply enjoy reading, discussing, and otherwise interacting with the works
(an example is seen below in fan-fiction). For some fans, this, however, is not enough. These
fans identify with, and truly want be or otherwise emulate, their favorite characters within these
books. This is evidence that these fans are interacting with the ideas and characteristics of these
fictional characters on a truly deep level.
The strongest evidence exists for people wanting to be Bella Swan. There are multiple
groups on the internet through Facebook.com, Fanpop.com, and Expereinceproject.com for
people who claim to want to be Bella (“I Want to Be Bella Swan”; “I Want to be Bella Swan.
<3”; “Do You Want to be Bella Swan?”).3 In fact, people not only want to be Bella, but they see

15. themselves as a Bella. In one of the communities, on Fanpop.com, someone calling themselves
“bellaroseswan” said, “i already is like bella brown hair and trip over and i also have a friend
caLLed jacob but not an edward yet” (“Do You Want to Be Bella Swan?”). This person views
themselves in Bella identifying with her appearance and clumsiness. Further, there are products
that are marketed to individuals like “bellaroseswan.” On Etsy, people can buy items which read,
“I’m just a Bella waiting for my Edward” with variations such as Baby Bella (“Twilight Bella
Waiting for Edward on Etsy”). Products such as this imply many fans see Bella in themselves.
Finally, through Yahoo.com, Fanpop.com, and Answers.com, there are multiple guides
teaching people to act and look like Bella. The clothes and makeup are not as disturbing as
people completely changing who they are in order to become like a fictional construction. These
guides encourage people to be clumsy, shy, well-read, intelligent, selfless, and be interested in
domestic activities (“How to Act Like Bella from Twilight”; “How to Be Like Bella
Swan?!**10PTS PlzAnswer!!**?”; “How Can You Be Like Bella Swan?”). While this may
seem innocuous, it is not entirely so. These could be simply that guides to help someone improve
their role-playing character, but the spirit of these documents seems to go beyond this. These
guides encourage a full shift in identity. On Answers.com, one guide actually suggested
mimicking Bella’s “scrawly writing” (“How Can You Be Like Bella Swan?”). By following
these guidelines, a person undertakes a transformative process to change themselves from a real
person into a fictional character.
Some guides, however, seem to understand that it may not be in an individual’s best
interest to change themselves based upon Bella’s constructed personality. For example, one
Wikihow.com guide provides the following warning:
“Don’t ever, EVER try to change yourself. Realize that Bella is merely a fictional

16. character in a book, and realize that she has massive flaws. If this doesn’t sway you, then
stop to think for a moment- would Edward want Bella at all if he saw that she was trying
to be something that she was not? Your real soul mate will love you for who you are, not
for who you think you should be” (“How to Act Like Bella From Twilight”).
It claims that one should act like themselves, but it is entitled “How to Act Like Bella from
Twilight” instead of something like “An Analysis of Bella’s Behavior in Twilight” or even “How
Bella Acts in Twilight.” This warning explicitly states the point that has been seen across various
sites. People want to be Bella because they want to be loved the same way that Edward and
Jacob love Bella with no regard for other factors.
Compared to Bella, or even Katniss, there is no discussion about people wanting to be
Lissa Dragomir. Fans of Vampire Academy seem to express their love of these books in a
different way. Part of the culture in Vampire Academy is a series of tattoos, which while
normally received by dhampirs like Rose can also be granted to moroi. These are mainly the
promise mark and molnija marks, which signify one's status as a guardian and the number of
strigoi one has killed. Placed on the back on the neck, these tattoos resemble a snake or an X
(Vampire Academy 13). Although dhampirs, moroi, and strigoi are not real, according to
Vampire Academy: The Ultimate Guide there are readers who are getting these tattoos (“What
was the Inspiration for the Guardian’s Tattoos?” 283). Unlike fans getting tattoos inspired by
novels, such as Katniss’s mockingjay pin, these are readers who are getting actual tattoos from
the novels. While the fans may consider this simply an homage, it can be considered more. By
getting molnija marks, they are emulating the characters in the novel in a permanent and visual
way. Lissa never receives these tattoos, so these readers are emulating Rose instead. Since Rose
spends time in Lissa's head, a reader emulating Rose is one who would be accepting of Lissa as
well.
Katniss has traits that are undesirable, but people may still desire to be her. For example,

17. a post on Yahoo Answers posited this issue. On Yahoo.com, someone using the name “whatever”
asked, “I've read all the books and I’m also re-reading 'em because they're so damn good! I want
to be Katniss so bad!!! =( Anyone else have the same feeling?,” but out of the five answers no
one responded that they too wished to be Katniss, citing her life situation and aspects of her
personality (“Whatever”). As Katniss becomes a pawn for various governments, is continually in
danger, and cannot escape the memories that torment her, it may be hard to imagine anyone
wanting to be her.
Despite this, there are appealing characteristics of Katniss’s construction. Despite having
a difficult home life, Katniss has grown into a strong, independent young woman capable of
caring for herself. Perhaps her less than ideal family situation allows this. When Katniss’s father
died, Mrs. Everdeen escaped into her own world, leaving Katniss to pick up the pieces. While the
situation seemed desperate at first, it evolved into one in which Katniss had near freedom. This
may appeal to many adolescents. There are many teenagers who view their parents as oppressive,
and Katniss’s freedom would appeal to them. In addition, Katniss’s success despite her troubles
may appeal to a different group of teenagers, those whose home lives are also less than perfect.
These people can see Katniss and her ability to fix things and aspire to that.
Finally, Katniss is surrounded by people who care for her and love her. Even removing
her mother and Prim, Katniss, is a part of a love triangle. While Katniss may not appreciate Gale
and Peeta vying for her attention, many young people do. Many people would love to have one
person they could be so sure of, let alone Katniss’s two. Regardless of the readers’ potential
preference for one character over the other, Katniss has a surety of these characters love that
many people would appreciate. When Katniss comments upon how she has no one she is sure
loves her except for Gale and her family when Peeta shows up in Mockingjay, she does still have

18. Gale. This is something many teens would desire.
There is direct evidence of many people saying they want to be Bella, and at least, one
person wanting to be Katniss. While this is not directly seen for Lissa, she still has desirable
qualities. These fictional characters have freedom, love, and friendship in ways that readers may
yearn for. As Pierce pointed out, fantasy is a “literature of empowerment” (51). These works
have created characters who are empowered to create better lives for themselves. It is probably
an expression of the readers’ lives that these characteristics stand out beyond the negative,
potentially stigmatized existence of these characters. For this generation's young readers, having
depression might not be a big deal. As Muhlbauer found in her study of effect of mental illness
on family members, teens may not be stigmatized for taking medication for a psychiatric illness
(79). Therefore, the character's mental illness-like traits may not play a significant role for these
adolescents. They see the absence of things in their lives, such as loving friends or significant
others, and want to be these characters in order to fill this void. Even when people are subject to
stigma, it might not matter. These readers have imperfect realities, so fear of the less than
perfect, including stigma, does not affect them.
An Introduction to Bibliotherapy
I ascertain that as readers read and interact with a book, they may learn from it, but this
says nothing about how they learn. I therefore have chosen to examine the general ideas behind
bibliotherapy. While I am more interested in the nondeliberate attaining of lessons through one's
normal reading process, there are links that can be made from examining the more precise
process of bibliotherapy. Bibliotherapy is the use of books as a therapeutic tool to help people
deal with issues (Prater et al 6; Heath et al 564). Although the term was coined by Samuel

19. Crothers in 1916, the process is much older (McKenna 498). There is evidence of healing
through books dating back to the libraries in ancient Greece and Egypt (Heath et al 563). The
modern idea of bibliotherapy has evolved from what used to be called insane asylums and
“moral therapy” into a more structured process involving psychologists and cognitive behavioral
therapy (Levin and Gildea 89-90). Bibliotherapy is often considered to be the use of self-help
books, either with or without the help of a professional (Cuijpers 140). There has, however, been
some work on the use of fictional works as tools of bibliotherapy, which has found that while
there are drawbacks to this process (Cuijpers 140-1; Prater et al 6; Heath et al 564-5). For
example, literature may not be available on a topic, or it may not be an appropriate therapeutic
tool for a certain condition (Prater et al 6; Heath et al 565) In addition, when an individual
chooses to buy a self-help book, they may not select one which will actually treat their symptoms
(Cuijpers 140). Despite these drawbacks, bibliotherapy can be beneficial for many people
(Cuijpers 140-1; Prater et al 6; Heath et al 564-5). Bibliotherapy can provide a cheap, easily
accessible form of therapy, which some may view as less stigmatizing than other forms of
treatment (Cuijpers 140-1). This may make it more appealing to many people.
Furthermore, bibliotherapy can also be performed in an educational setting by teachers or
school psychologists either individually, or as a group (Prater et al 7). In this type of setting,
bibliotherapy allows the students to express themselves providing a safe and fun way for students
to compare their behaviors to others and learn new ways to manage their problems (Prater et al
6). While bibliotherapy with a group such as an entire class, may seem like simply a learning
opportunity, it goes beyond that. For example, a teacher could decide to do bibliotherapy to
address a natural disaster that hit a school nearby to help students deal with the tragedy. Rather
than directly teaching, these literary texts provoke an imaginative response on the part of the

20. reader (Silverberg 131). Tussing and Valentine state that the use of young adult fiction books can
allow someone to connect with the character while maintaining a safe distance (458). Their study
of bibliotherapy using fiction for adolescents who have a parent with a mental illness found that
many fictional books have characters with healthy coping skills (Tussing and Valentine 466). I
will show later that some readers may be interacting with books in this manner without calling it
bibliotherapy.
When a teacher or school psychologist chooses to use bibliotherapy with a young person,
there is typically a process that is implemented. This process involves building rapport; finding
others who can help such as teachers, psychologists, or librarians; receiving consent and
approval from the child’s parents or guardians; identifying the exact problem; planning activities
to address the problem; selecting an appropriate book or books to deal with the issue; giving the
child the book; reading the book with the child; doing post reading activities with the reader and
finally, examining what effect the process had on the student (Prater et al 7). An alternate way to
examine bibliotherapy is from the point of view of the reader, looking at the psychological
changes they undergo. First, individuals become involved in the reading process. They identify
with the characters and circumstances in the story. Once readers are involved, there can be an
emotional release, as a result of living through the characters in the story. Readers can then use
the story to gain insight into how the circumstances in the book might be applied to their own
lives. Finally, they are able to move beyond their own problems and recognize that others can
have the same issues (Heath et al 567-8). This process is ultimately able to occur because the
reader identifies with the characters in the books (Silverberg 132). Unlike the steps described
above of how one would lead someone through bibliotherapy, these steps show how and what
effect bibliotherapy has on a reader.

21. Duffy has expanded this analysis of the psychological process, proposing a “hero's quest”
bibliotherapy for adjustment disorder (Duffy 1). This treatment uses the archetype of the hero's
quest and challenges participants to understand their circumstances under the arc of the hero's
quest in the literature they use (Duffy 8). This framework is then used to work through the steps
described by Heath et al (Duffy et al 8–12). Duffy believes that reconceptualizing adjustment
disorder using the hero's quest empowers and destigmatizes those who will use this process
(Duffy 14). This empowerment of the reader mirrors the empowerment seen in the characters. As
readers identify with characters, this empowerment can be seen even if it is not specifically
fostered.
In fact, this process can be facilitated without referring to the idea of bibliotherapy
because readers can interact with literature in ways that follow these psychological processes
without thinking of it as therapy. A recent article about implementing a critical reading program
in secondary English classes said, “Reading young adult literature can be a powerful way for
students to develop critical literacy skills and reflect on their own experiences” (Curwood).
Curwood calls for such books to be used to teach students about disability including mental
illness. Further, this process calls for students to think about the material they read and develop
new thought patterns as a result (Curwood). Without ever using the word, Curwood proposes the
use of books in a similar manner to what Prater et al classifies as bibliotherapy. As another
example not using the specific term bibliotherapy, Whitley believes that memoirs of mental
illness can be used to provide hope and support to individuals with severe mental illnesses (358).
The way readers interact with content in a book is important in how they internalize ideas
seen within the literature. In bibliotherapy, this is traditionally referred to as post-reading

22. activities. These activities allow individuals to process what they have learned encouraging
emotional growth. There are a number of different activities that are used to check for
understanding (Heath et al 570). These include creative projects such as drawing pictures,
retelling the story, or continuing the story (Prater et al 9). Readers may in fact be undertaking
these sorts of activities of their own accord as I will shortly discuss.
While traditional bibliotherapy is not my focus, there is a correlation to be drawn between
the emotional process individuals go through and the way some readers interact with a book. As
fans interact with a book and are drawn into it, they allow themselves to identify with characters,
they allow themselves to learn from and potentially be transformed by the books. This is
especially true when fan activity mirrors the post-reading activities seen in more traditional
bibliotherapy.
Fan-Fiction as a Form of Post-Reading Activity
As mentioned, post-reading activities are important in the bibliotherapeutic process. If I
am stating that some readers may be learning lessons without formally defining it as
bibliotherapy, then it is important to examine self-directed post-reading activities. One of these
is fan-fiction, which is the writing of stories by fans in the storyworlds created in a previously
established work such as a movie or novel. This activity is of particular interest to me as fan-
fiction plays a couple of very distinct roles. It mirrors one of the post-reading activities suggested
in which the readers write what happens to characters after the story ends. This is very similar to
what happens in many “fanfics,” or stories of fan-fiction. Second, fan-fiction is a way that
readers can explain all the different what-ifs of a story by telling it different ways.
To explain how stories can be told in different ways and the impact thereof, I will draw

23. from the field of narrative ethics. In her essay, “Context: Backwards, Sideways, and Forward,”
Hilde Lindemann Nelson makes this point for clinical cases and discusses the ethical
implications of being able to tell a patient's story in these different ways. Traditionally, context is
only interesting for as long as it takes the practitioner to figure out the correct principles and
rationales needed to make an ethical decision with the ethicist acting as judge mandating what
should be done. In this way, the patient's story has a single focus, leaving out many important
details that could be considered if the story was told from another perspective (Nelson 39).
Nelson then uses this to discuss the possibilities of what can happen if the patient's story is told
in different ways by defining backwards, forwards, and sideways told stories. Nelson describes
stories told backwards as ones providing details to tell what someone does over time. Sideways-
told stories enlighten readers as to what is going on as it goes on. It provides social context to
things that are going on as opposed to the basic facts (Nelson 42). In the forward told story, the
writer analyzes all the elements and points of view found in the backwards and sideways told
stories and uses these elements to make an assumption of where to go from here (Nelson 45).
While Nelson was speaking strictly in terms of making ethical decisions for patients in the
clinical setting, the way that fans interact with and retell stories through fan-fiction can have a
similar effect as I will show through examples of stories utilizing these ideas.
Nelson's concept from narrative ethics may seem oddly placed within a section about
fiction and fan-fiction in particular, but, as fans tell and read stories, they interact with very real
information about mental illness in society in different ways, allowing stories to expand the
storyworld into the real world. Fans write stories using not only the information found in the

24. different books, but with all the extra details they can find.4 As different people take different
view points, or even the same person writes different stories, it creates different points of view.
I found a number of different stories that do this. I searched for stories on
Archiveofourown.org and Fanfiction.net, two of the largest sites for online fan-fiction, which use
the language I look at more closely in this work. I further looked for stories that take place
during gaps of the original narrative (i.e. I searched for pre-epilogue Mockingjay stories). I read
through numerous stories, and I selected these examples to show the variety of different ways
that fans use these stories to explore various situations that could have happened, but did not in
the novels. These examples encompass all the works I explore. In regards to New Moon, Bella
may be forced into therapy where she is required to maintain a blog about her experiences
(“orphan_account”). In another situation, Bella might react in such a way as to never need
therapy in the first place (“evilember”). For Vampire Academy, Lissa might start cutting again
with the horrible results not seen in the novel (“yamimagiciangirl'). Perhaps, instead of Lissa,
Rose will be depressed and cut (“DimitriandRose7”). Finally, in works based off The Hunger
Games series, Peeta and Annie could live in a modern society where Annie has obsessive
compulsive disorder and Peeta is schizophrenic (“haka_nai”). In another example, one could
ignore the characters Suzanne Collins focuses on in The Hunger Games to explore the mental
effects of other victors over the years (“AdrenalineWrite”). Nelson points out that the narration
of an ethical dilemma from different points of view can lead to different conclusions and
decisions. In the same way, each of these stories provides a different point of view, which can
lead to different ideas allowing the fans who read these stories to gain different insights than the

25. ones from the original books. In this way, these stories act as different narratives showing
various as-ifs affecting what these fans learn.
Fan-fiction is not a rare phenomenon, and on Fanfiction.net and Archiveofourown.org,
there are many stories based upon these books. In fact, on Fanfiction.net, these three series range
from number two to number thirteen in terms of popularity (“Books”). A young reader, dealing
with issues similar to the characters, can post stories in which they change elements and the
eventual outcome to whatever they want. This is something that can be seen in the stories above.
Further, these fans can envision themselves as the main characters as they write. Perhaps,
thirteen year-old “DimitriandRose7” likes Rose better than Lissa, but deals with depression
herself and this is why she made the changes she did as she wrote her story. This identification
may not be obvious, but it can occur as young readers write about their favorite stories. For this
reason, this interaction through writing is important as it reinforces the ideas the readers are
manipulating and ultimately solidifying the ideas learned from the literature in the minds of the
young readers.
Where I Am Going From Here
Within this introduction, I have explored many of the ideas that are essential to the
overall shape of my project. I believe teens are using these books as a starting point to discuss
serious topics. The readers may internalize the ideas using the same emotional processes
essential to bibliotherapy. Since New Moon, Vampire Academy, and The Hunger Games are
popular many young individuals read these novels and see the movie adaptations and, it presents
an opportunity for many individuals to absorb these ideas. As this is a subconscious learning
process, there are no explicit lessons, but that does not mean that there is not some degree of

26. knowledge absorption. Therefore, it is important to examine the different ideas that these novels
present about mental illness. These ideas pertain to different areas of the mental illness
experience and show the kinds of ideas that the readers themselves are exploring through
discussion. I selected topics that are either seen across multiple works or are a major topic of
discussion by readers. I analyze these reader discussions bridging the storyworld and the real
world and allow for the comparison between speculative and real. Reader comments are used to
show that readers are examining these ideas in the novels not only in terms of the fictional
storyworlds but also in the real world. Because of this departure from the fictional, I use social
science and bioethics research to show how the fictional ideas pertain to real world ideas and
beliefs. I perform this analysis across five different areas. First, I explore the ideas of illness
experience and recovery. All of the characters have different experiences even if they display
symptoms of the same condition. Further, mental illness does not preclude a happy, normal life.
Second, I look at the role of friendship in mental illness. Within the novels Jacob, Rose, and Gale
support Bella, Lissa, and Katniss show support by friends can play a major role in one's mental
illness-like condition. Third. I look at Bella's reckless behavior. Fourth, I explore labeling and
self-labeling. The labels used to describe someone affect how they view themselves. The
labeling of a condition as a medical problem can have this effect, but this phenomenon goes
beyond this. In particular, the effect labeling is had is seen in the experiences of Bella and
Katniss. Finally, the fifth topic is the way treatment decisions are made. In order to make
treatment decisions for themselves, an individual muse display decisional capacity. None of the
characters explored have the capacity to make their own decisions due to a combination of the
symptoms of their mental illness-like conditions and age. Therefore, these narratives provide
examples of the way proxies make decisions for individuals who do not have (or are not judged

27. to have) capacity. Ultimately, this exploration of these ideas will provide guidance as to how
individuals should approach these books.

29. II. Mental illness does not need to define someone's life. Everyone's
experiences are different.
“Meyer so eloquently handled that feeling of emptiness (I adored the bit at page 85
where Meyer just wrote the months on the following pages. What a brilliant way to
sum up depression without overdoing it).”
- “Karusichan” on Amazon.com
This quote summarizes and approves of the way Meyer constructed Bella's experience
with a depression-like state. “Karusichan” appreciates that Meyer was not afraid to let there be a
void in the plot, for this void depicts the nothingness found within Bella's depression-like state.
This is something that is unique within the novels I examine: The mental illness-like
presentations are different in each book I examine. Because there is no rule or defining feature
for what it means to be a person with a mental illness, people can have varied experiences both
in literature and the real world. In this section, I explore the experiences of the different
characters and compare them to those of real people. There are many similarities between all of
these works (the presence of female, adolescent protagonists, rural settings, homodiegetic
narrators, and mental illness-like conditions to name a few), but these similarities do not
overpower the differences. I use the homodieagetic narrators (narrators who are part of the story
world) to see how these characters describe their experiences in a fashion that mirrors the way a
real person would describe their experience. All of the characters display a different illness
experience. Bella and Lissa display symptoms similar to depression while the experiences of
Annie, Peeta, Katniss, and Finnick vary greatly in their descriptions. The experiences of real
people reflect this great diversity. I will break down this section to examine each description
singularly.5
Obviously, the way that one person reads a book is not the way that everyone will read

30. the same book. While “Karusichan” appreciates Meyer's representation others may not. When we
read, our reading is shaped by our knowledge and experiences. Because of this I will present a
fan perspective after each illness experience. These descriptions are drawn from discussions of
these fictional illness experiences in Amazon.com reviews, individual blogs, and discussion
groups. In some posts, the reader viewed the experiences in much the same light that I do, but
others view the experiences very differently. This further supports the idea that there is no cookie
cutter image for mental illness.
Bella's Experience in New Moon
Edward leaves Bella, triggering what readers perceive as an episode of depression (New
Moon 68-70).6 Bella's father, Charlie, recounts a doctor describing Bella as “catatonic” (New
Moon 396). The doctor’s involvement, and his terminology, evokes the idea that this is a clinical,
medical depression as opposed to Bella’s simply being upset due to the loss of her boyfriend and
the friends she had made within his family. Specifically, Charlie describes Bella's behavior after
Edward leaves, saying, “She wouldn’t eat or drink, she wouldn’t move. . . [Then she] went back
to school and work, she ate and slept and did her homework. She answered when someone asked
her a question. But she was . . . empty” (New Moon 396). Although Bella appears to have begun
to be functioning again after that point, it is without her personality. In this new state of being,
Bella is described both by herself and others as a “zombie” (New Moon 106). There is a body,
but it lacks the personality that makes Bella herself.
In fact, this “zombie” lacks the words to tell Bella's story. Bella as narrator describes the
initial coming of this state as a dark wave that had come over her from which she did not
resurface before failing to narrate her story for three months (New Moon 84-91). Bella has
nothing to say about her life for the months of October, November, and December. This gap

31. leaves a hole in the narrative which readers must fill in on their own using clues such as the rest
of Charlie’s quote above.
Bella’s situation becomes worse before it gets better. Edward made Bella promise not to
do anything reckless (New Moon 71). This, however, is not a promise she can keep. She
inadvertently discovers that when she behaves recklessly, she can hear Edward’s voice.
Although Bella seems to recognize that this is not normal behavior, she still chooses to partake in
activities such as motorcycle riding and cliff-jumping that she considers to be “reckless and
stupid” (New Moon 127). I will explore this more in a later section, but ultimately, Bella is able
to fully recover with no long term damage and has her happy ending.7
Fan Views of New Moon
People seem to have very mixed opinions about Bella's depression-like experience in New
Moon. Some people view Bella's experience as authentic. It reminds them of their own break-
ups and/or past with depression. Others view Bella's experiences in a negative light. They view
Bella as melodramatic, over the top, or even sociopathic.
First, there are the people who view Bella's experiences in a positive light. On
Amazon.com and Fanpop.com, readers such as Grace Rostoker and one using the handle
“HerMelody” use their experiences with depression to discuss Bella's behavior. HerMelody says
that along with depression her poor self-esteem allows her to view Bella's experiences as a
reflection of the way depression can manifest. She explicitly discusses how depression can make
one dependent upon others the way Bella is dependent upon Edward and Jacob. She reminds
others that different people have different experiences, and while someone may view Bella as a
bad role model, she is a reflection of what depression can really look like in an adolescent

32. (HerMelody). Rostoker comments that hidden depressions combined with acting normal was
exactly what she felt, and it was so realistically portrayed as to trigger those feelings in herself.
These readers discuss Bella's experiences beyond her relationship with Edward.8 Some
reviewers can relate to Bella's experiences. Depression is not simply an artifact of the story. It is
a part of the real world. Another Amazon.com reviewer comments on people who believe Bella's
experience to be unrealistic saying, “But to those who say Bella is 'selfish, she trying to kill
herself, depression is a bad example to give kids', I think you need to look around you. And It
makes me wonder if you are not talking about yourself” (Ayesha). In doing this, the reviewer
called other readers to question their own experiences and those of their friends and family,
comparing them to Bella's.
In contrast to the points above, many readers are not able to see anything good in Bella's
experiences. In his blog, one reviewer calls Bella a sociopath and describe people like those
above as disturbed (Antwiler). It is actually a device within those that criticize Twilight to make
fun of the way Bella's depression-like state is described. Another blogger views the lack of
narration as the “lamest” narrative device used to describe the blankness of depression he has
ever seen (Marovich).9 A third blogger jokes how harsh “waves of pain” can be to experience
(Will). These readers view New Moon as a parody of depression and angst (Eddo-Lodge).
Others take a different approach to point out their issues with Bella. Some choose to
retell the story focalizing on another character to uncover a different possibility. As stated in one
article, for Charlie, this story is a parent's nightmare of depression, accidents, and lack of
communication (Franich). Further according to a blog on Ew.com, it is a story of unhealthy
relationships and stupidity on Bella's part. This is seen in both her relationships with Charlie and
her friends (Bierly). As one of the readers I already introduced suggests, one's friends always get

33. a kick when their friends become involved in dangerous situations against their will (Marovich).
These readers have proven to be critical, cynical even in their views of Bella in New Moon. They
use different methods to show their criticism, but that does not make their sentiment any less
true. These readers do not care for the way Bella is presented.
In regards to Bella's happy ending, readers continue to have mixed feelings. HerMelody
uses her own experiences to point out that perhaps Bella's ending at the end of New Moon is
perhaps not as happy as it could be. She suggests that Bella may always be living a sort of partial
life even if appears to be a happy ending. On Schmoop.com, another reader buys into Bella's
happy ending noting a number of readers skipped to the end to guarantee this kind of fairy tale
ending (“New Moon”). Bella is a stronger person after her experiences in New Moon. It is only
because she comes through this episode that she is able to get her happy ending.
Experiences in Vampire Academy
Richelle Mead’s Vampire Academy opens with Rose saying, “I felt her fear before I heard
her screams. Her nightmare pulsed into me, shaking me out of my own dream” (Vampire
Academy 1).10 Throughout Vampire Academy, Lissa suffers uncontrollable emotions and often
feels like there is someone following her (Vampire Academy 53). All of a sudden, Lissa will feel
like she is “drowning in her own pain” over any number of things (Vampire Academy 260). As
Lissa’s moods become increasingly intense, Lissa feels the need to take desperate action,
ultimately cutting her wrists. Rose describes, “Perfect lines crossed her wrists, not near any
crucial veins, but enough to leave wet, red tracks across her skin” (Vampire Academy 158). In
fact, Lissa is undertaking a type of nonsuicidal self-injury, since she is using her cutting behavior
to achieve relief from her negative feelings (American Psychiatric Association 803).1112
Eventually, it is discovered that Lissa carries a tiny razor blade with her at all times (Vampire

34. Academy 260). This implies these incidents happen with a degree of regularity, and Lissa wants
to be prepared.
Soyna “Crazy” Karp is a former teacher at St. Vladimir’s, the school Rose and Lissa
attend, and displays a similarity to Lissa. Another pupil at the school describes her saying, “Man,
you should have seen this messed-up teacher we used to have. Used to think people were after
her and would go off on stuff that didn’t make any sense. She was nuts. Used to wander campus
while everyone was asleep” (Vampire Academy 71). Rose reports seeing marks on her forehead.
Regarding these she says, “Sometimes there were new marks; sometimes the old ones faded to
nothing” (Vampire Academy 132). This implies that that Karp displayed ongoing self-mutilation.
While Rose does not think Lissa is “nuts”, she realizes that others may. At one point when Rose
is talking to Karp, a number of guardians, or bodyguards, arrive to take Karp away from the
school. Rose states, “The guardians had later explained to me that she wasn’t well and had been
taken to a place where she could recover. She would be safe and cared for, they assured me. She
would recover” (Vampire Academy 200-1). Based on the way that Karp is remembered by
students, it makes sense that Rose and Lissa try to keep Lissa’s behavior secret. Lissa fears she
will be taken away like Karp if others discover her secret (Vampire Academy 264).13 While this
does not happen, Lissa is given a hard time from her peers, but once she receives treatment,
Lissa's moods stabilize. Lissa is able to remain a Moroi in her school and get the help she needs
(Vampire Academy 325).
Finally, St. Vladimir is a person like Lissa and Karp.14 Rose reads St. Vladimir’s diary
and discovers St. Vladimir suffered from depression and had once attempted suicide. Based on
accounts written by St. Vladimir and one who knew him, Rose realizes that Lissa and St.
Vladimir share more than just a bond (Vampire Academy 199).

35. Lissa, St. Vladimir, and Soyna Karp all specialize in Spirit. This magic allows them to
heal others (Vampire Academy 296). It even forged the bond between Lissa and Rose, when
Lissa brought Rose back from the dead. Along with creating their bond, this healing begins the
spiral downward into depression for Lissa (Vampire Academy 253). Spirit comes from the user
exhausting and leaving them depressed (Vampire Academy 297-8). This magic can be both a
blessing and a curse for the user. It can allow the user to do miraculous things, but it also wrecks
the user emotionally.
Ultimately, these characters must find a way to control their moods. Soyna Karp does this
by cutting herself off from the magic completely becoming strigoi. St. Vladimir and Lissa both
have spirit bonds to others that can help them. Beyond this, Lissa seems to be able to regain a
sense of normalcy by taking medication.15
Fan Views of Vampire Academy
There is less debate within discussions of Lissa's description than there is for the other
characters. On a blog, one reader points out that Mead has constructed an authentic view of what
depression is really like, wondering if the author was drawing upon personal experience (Sarah).
On Dearauthor.com, a different reader points out that Lissa's need to take care of others makes
the situation worse for herself (Jacobson). Thirdly, an Amazon reviewer says, “A crazy teacher
at the academy once told Rose that she needed to make sure that Lissa didn't use her magic. The
girls didn't quite understand why but make no mistake they will figure out the hard way” (Escape
in a Book). In her personal blog, a fourth individual points out how Rose endeavors to protect
Lissa, pointing out that they conspire to keep Lissa's secret and makes a point of Lissa's isolation
from most of her peers (Stander). While these discussions do not explicitly mention the darker

36. aspects of Lissa's behavior, Catie Taylor does. On Amazon.com, Taylor says, “Second, self-
mutilation is a huge issue in this book.” In addition, as stated on Amazon.com, for Tez Miller, the
fact that Mead does not shy away from talk of mental illness makes her wish St. Vladmir's were
real. Finally, the first reader concludes with a comment about Lissa's friends supporting her
assuring she got the help she needs as well as supporting her in a number of potentially smaller
ways saying, “They don’t try to pretend it’ll all be ok, distract her, or try to cheer her up with
glib comments” (Sarah). All of these readers seem to view Lissa's experience with some
authenticity. They do not think she is being weak; they view her as a depressed individual who is
supported by her friends.
Experiences Within The Hunger Games
In The Hunger Games, and the third volume, Mockingjay, in particular, there are more
characters with differing experiences than in the other works. Due to the diversity of these
characters and the distance between modern terminology and that used in the futuristic world of
Panem, I group these characters by situation. Further, to limit the scope of my discussion, I have
chosen to focus only on three types of experiences within this section, those of Annie, Peeta, and
finally, Katniss and Finnick. These were chosen due to the depth and uniqueness of their mental
illness-like experiences. While all of these characters seem to be displaying some level of
reaction to their time in the arena, this makes sense. In psychiatric terms, a traumatic event is
defined as,
Exposure to actual or threatened death, serious injury, or sexual violence in one or more
of the following ways:
1. Directly experiencing the traumatic event(s)
2. Witnessing, in person, the event(s) as it occurred to others
3. Learning that the traumatic event(s) occurred to a close family member or close

37. friend. In case of actual or threatened death, the event(s) must have been violent or
accidental
4. Experiencing repeated or extreme exposure to details of the traumatic events(s)
(American Psychiatric Association 271).
Therefore, all of these characters have experienced events which, if they lived outside of the
storyworld, would be classified as traumatic, and it should come as no surprise that these events
have transformed these characters.
The “Mad” Annie Cresta
From the moment readers meet Annie in Catching Fire, she is labeled as “mad.” She
went mad after seeing her district partner killed in the arena and never recovered. She remained
too unstable to participate in the games through the means expected of Victors such as mentoring
tributes and providing interviews about their experiences (Catching Fire 442). This is
reinforced in Mockingjay: President Coin says, “Oh, the mad girl. . . We don’t make a habit of
punishing anyone that frail” (Mockingjay 57). Annie’s behavior is unstable (Mockingjay 225).
As Katniss describes, “She laughs at odd places in the conversation or drops out distractedly.
Those green eyes fixate on a point with such intensity that you find yourself trying to make out
what she sees in the empty air. Sometimes, for no reason, she presses both her hands over her
ears as if to block out a painful sound” (Mockingjay 225). This is the best description of Annie’s
behavior readers are given.
Annie’s behavior may not be normal in Panem, but it is not all that different from
Katniss’s own habit of hiding. Both characters are prone to what psychiatry labels dissociative
symptoms. Dissociation is defined as a perceived detachment of the mind from either certain
emotions or body, leading to a dreamlike feeling and potentially poor memory of an event
(“Definition of Dissociation”). It is not unusual for someone who has been exposed to the level
of trauma any victor must go through to win in the Hunger Games.17

38. “Hijacked” Peeta
Initially, Peeta’s experience is similar to Katniss’s. He suffers from nightmares, which
seem to be alleviated a little by painting (Catching Fire 72-74). This changes when he is taken
to the Capitol, where he is “hijacked.” Hijacking is the term used to describe mind control and
fear conditioning in Panem (Mockingjay 180). As Katniss says, Peeta has become “damaged” by
the Capitol (Mockingjay 182). While the etiology may not be organic, Peeta’s behaviors for the
most part are mental-illness like. Once he leaves the Capitol post-hijacking, Peeta’s mental state
is a result of all of the combined trauma to which he was exposed. He can be triggered from a
relatively normal state to “The land of the hijacked” (Mockingjay 279). In this state, Peeta's
actions are unpredictable and dangerous to those around him. He is no longer a person, let alone
the person he is in the previous books. Peeta concludes that he has been transformed into a mutt,
a form of Capitol weapon (Mockingjay 290). Post hijacking, Prim suggests people outside the
Capitol could “hijack him back” (Mockingjay 195). This implies hijacking can be undone
through its doing. The process of hijacking the hijacked is painfully slow, and milestones are
measured in feeding himself and confusion replacing terror (Mockingjay 195-6). This process is
fairly successful as Peeta is able to live a life wherein he is neither locked up, nor hospitalized
(Mockingjay 382-90). In a work of fan-fiction narrated by Peeta, he says, “I was luckier than
most. I got to marry and have children with my one and only love. We went through every shade
of hell to get to our Happily Ever After, but I got to marry the girl I'd loved since I was five”
(Titania522, “The Cloth That Feels Like Love Itself”). While this quote is not in the novels, it is
an excellent summary of Peeta's experiences in Mockingjay.

39. Katniss and Finnick: “Mentally Disoriented”
At the end of Catching Fire, Katniss worries that she has gone crazy fearing she has
become like Annie (493). Mockingjay expands upon this idea. Rather, Katniss is “MENTALLY
DISORIENTED.” These words are stamped onto her second medical bracelet in District 13, so
all can see and know (Mockingjay 352). Katniss’s experiences are the experiences of a mentally
disoriented person. Her experiences as such are complex and confusing, and while the term is
never explicitly applied to Finnick, Katniss’s descriptions of Finnick’s experiences lead readers
to believe he is “mentally disoriented” as well.
After being a pawn in the Capitol’s games, Katniss is no longer able to maintain the
image others expect of her, but this label forces others to tolerate her behavior (Mockingjay 18-
9). Katniss is unable to conform to life in 13. Katniss, therefore is depicted as assuming a fake
bravado flaunting her medical label requiring others to accept her as she is. Katniss blames her
confusion and nightmarish departure from reality on the medication, but there is likely more to it
than that. She describes, “The drugs they use to control my pain and mood sometimes make me
see things. I guess. I'm still not entirely convinced that I was hallucinating the night the floor of
my hospital room transformed into a carpet of writhing snakes” (4). One of the defining traits of
Katniss’s experiences as someone who is mentally disoriented is a tendency towards episodes of
dissociation.18 In Catching Fire, Katniss displays not only nightmares, but flashbacks when she
is awake (74; 98; 57). Near the end of the novel Katniss returns to her wandering habits. She
says, “My places are dim and quiet and impossible to find. I curl up, make myself smaller, try to
disappear entirely. . . I wouldn't much care except the sight of my body brings back the memory
of the pain. And why I was in pain. And what happened just before the pain started” (Mockingjay
351-2). This is probably the description Katniss gives of what it is actually like to be disoriented

40. and how it maps onto the idea of dissociation. There is a direct wandering behavior, which is at
least in part due to wanting to avoid pain. Katniss has a physical response to emotional stimuli
building upon behavior she develops while mentally disoriented in 13.
Finnick Odair is the character to whom Katniss feels the most similar. This is obvious in
the way that she describes his mental state. Katniss says,
They want to transform Finnick into a rebel leader as well, but first they’ll have to get
him to stay awake for more than five minutes. Even when he is conscious, you have to
say everything to him three times to get through to his brain. The doctors say it’s from the
electrical shock he received in the arena, but I know it’s a lot more complicated than that.
. . He, at least, has some idea of what I’m going through. And it takes too much energy to
stay angry with someone who cries so much. (Mockingjay 11-2)
Katniss describes Finnick as a male, slightly older version of herself. He is dealing with both
physical and mental conditions. The way that Katniss describes people’s interactions with
Finnick is very similar to the way she perceives others interacting with her. He is a potential
asset that is dealing with physical and emotional issues as a result of his time in the arena.
Ultimately, Katniss must deal with her emotional issues as well. As I will discuss in the
treatment section, Katniss begins to regain a sense of normalcy once she begins to participate in
therapy. In the end, Katniss and Peeta come to accept that although they will never completely
recover from the traumatic events they survived, they can marry and have children together
(Mockingjay 390). This may not be the happy ending the other characters are given, but it is an
ending that can be construed as happy.
Summary for The Hunger Games
The experiences for Annie, Peeta, Katniss, and Finnick are varied, but not entirely
different. All of these characters experience trauma and must deal with their mental reactions as
a result. Peeta experiences go experiences go beyond the others due to “hi-jacking.” Annie may
seem completely different in her madness, but some of her symptoms are similar to Katniss’s and

41. therefore Finnick's. While the ending is not as happy as the other books, it is a happy ending in
that life is not truly a fairytale.
Language Used by Fans
Before I look at reviews, it is important to look at the language fans use in their reviews.
There are very specific terms Collins uses to describe her characters. For example, Katniss is
“Mentally Disoriented.” Reviewers of the book, however, frequently use other terms to describe
the characters. In this way, readers are breaking from the language of the book to use language
that society has taught them to use to apply to these types of behaviors. Some readers even
choose to diagnose the characters with mental illnesses from The Diagnostic and Statistical
Manual of Mental Disorders (DSM). By doing this, these readers are taking the conditions set
within the novels and suspending them. To these reviewers, these characters are no longer
characters written into the fictional world of Panem, and they may as well be people in the real
world for the way they are described.
After noticing this trend, I chose to explore it more in depth within Amazon.com reviews.
A summary of my results can be found in Appendix A. In reviewing Mockingjay, only six people
actually applied the term mentally disoriented. While another five used disoriented without the
qualifier of mentally, the combined eleven reviews is still a fraction of the eighty-five reviewers
who viewed the characters as having Post Traumatic Stress Disorder or PTSD. PTSD is a
psychiatric disorder classified by the development of characteristic symptoms after being
exposed to a traumatic event. The presentation of the symptoms can vary from individual to
individual including re-experiencing, behavioral symptoms, emotional symptoms, and fear-based
symptoms (American Psychiatric Association 274). The use of the term PTSD in application of
these characters is interesting because this term never appears in The Hunger Games series. The

42. reviewers making the leap from “mentally disoriented” to PTSD are using their own experience
and knowledge to make the leap from reality to fiction. There are three reviews I found which
bridge the gap between the real world and the story world to some degree using language that
ascertains the characters display symptoms similar to PTSD without ever outright saying the
characters have PTSD. This level of discussion shows the relevance of the books to the
experience of readers without completely abandoning Collins’s ideas.
Although one reviewer uses the statement “Peeta's illness (for lack of a better word”
(Bibliomaniac), interestingly, when it comes to Peeta's condition, reviewers seem more
comfortable using the language ascribed by Collins. Eighty-eight reviewers used a variation on
the term “hijacked” while only sixty used a variant on brainwashed. Once again, there were a
few reviews who use terms that fall between the two. Five reviews comment on the use of
tracker jacker venom in the transformation of Peeta. While these reviews do not use the term
“hijacking,” they use the devices of Panem to describe Peeta's condition. Perhaps, it is the
differentness of Peeta's “Hijacked” label that causes readers to identify with it more than
Katniss’s “mentally disoriented” one. Katniss simply becomes mentally disoriented, while Peeta
is hijacked using the tracker jacker venom. Since it is a specific process, then readers view it
differently from something that can naturally occur. Based on the way the characters are
described in reviews, a reader could become mentally disoriented, but due to the lack of tracker
jackers, it is impossible for readers to be hijacked.
The use of the PTSD label is not limited to reviews posted online. In her essay, “Bent,
Shattered, and Mended,” fiction writer Blythe Woolston specifically examines PTSD in The
Hunger Games. Woolston ardently believes that Katniss and her peers have PTSD, and as fans of
Collins read Woolston, they learn to do the same. Woolston attributes all of Katniss’s behavior to

43. this condition, yet Katniss cannot be diagnosed with “PTSD” as the DSM presents it. She is a
character in a fictitious dystopian future, so the current diagnostic criteria for PTSD should be
used more as a guideline for how readers frame their opinions of Katniss than as a tool for
analyzing her behavior. Katniss obviously is constructed in such a way as to describe herself as
having symptoms that readers view as PTSD, but Woolston seems to be reading the books as if
Panem were the real world. She is trying to make sense of the behavior of Katniss and her
fellow characters using language and criteria which are not fully applicable to these characters.
While readers take the knowledge seen within the storyworlds and adapt it to the real
world, I argue that it is important to examine the novels as their authors created them, I therefore
will retain the language and labels from the storyworlds whenever discussing the events from the
novels. I will only use modern language when it is either concurrent with that of the storyworld
or to maintain the language the reader uses in their discussion. This allows me to get an accurate
picture of what the authors constructed and how readers view these events. While Katniss may
be “mentally disoriented,” as the reviews above show that her experiences can still teach readers
about PTSD. This pertains to the ways in which speculative literature can teach about reality by
examining the differences from reality.
Fan Views of The Hunger Games
There are many readers who have expressed their opinion of The Hunger Games
characters. While most readers discuss Katniss, this is not always the case. Some readers discuss
Annie or Peeta. Like New Moon, readers view the different experiences in The Hunger Games in
multiple ways showing that mental illness is not cookie cutter.
On Amazon.com and in a The Hunger Games discussion board, several reviewers note

44. that Katniss struggles to understand her identity as a person (“Katniss Everdeen”; “***Fan
Question*** Changing Mockingjay.”). In a review on Tor.com, it is pointed out that this identity
includes not only Katniss’s private identity but her public one as the Mockingjay (McGovern).
Ultimately, the traumatic events she has undergone have had a transformative effect on Katniss.
In the above mentioned discussion board, Michelle D. comments the person Katniss really is is a
survivor (“***Fan Question*** Changing Mockingjay.”). Katniss has proven herself capable to
go on even when it seems unlikely, but that does not mean the constant trauma does not change
her.19 Decisions she may have made prior to her events in the arena are not the same ones that
she makes after this point.20 On Amazon.com, many reviewers believe Katniss’s transformation
is natural given her experiences (C; Mcvrxjen; Lambeth; Boz; Mj).21 For example, Shannon C.
writes,
While war is an agent of change and often a necessary evil, it is not glamorous. . . While
Katniss is often emotionally flat and seemingly numb to the world, I would argue that
this is a very real portrayal of the PTSD that anyone who had suffered through what she
had would experience. Likewise, I think Peeta and Haymitch are also excellent examples
of the toll that PTSD takes on individuals who have lived through tragedies. So while this
book does not end with rainbows and everyone smiling and holding hands, I think the
beauty lies in its realism. It is the raw emotional experience of tragedy and fighting for
what is right even what it is not easy.
These reviewers acknowledge that the nitty gritty of PTSD creates a nitty gritty novel.22
Further, in an Amazon.com review, one family therapist comments upon Mockingjay and
how it depicts the realities of what it means to go through life. When chaotic events happen, the
course one's life can take can change drastically, and this is a part of what Mockingjay presents.
This therapist believes “Katniss paints a picture of hope in that she experienced severe trauma
and was even "committed" and in a "drug induced stupor" but pulled through...” (A Brown). For
this reviewer, Katniss remains true to her character throughout the novels, but the character must
learn to adapt (A. Brown).

45. Most readers only discussed Peeta in terms of Katniss, but this is not always the case. An
example of this occurs when on his blog Markreads.net, one reader discusses how Peeta ices the
cake for Finnick and Annie's wedding. This achievement shows the progress that Peeta has been
able to achieve, and it allows this reader to become excited about his future potential for growth
and recovery (Mark). While it will be a long time before Peeta and Katniss are able to achieve
their happy ending, this scene gives the reader hope for a better future for Peeta than that that
seems likely when his is first hijacked.
In addition, on a private blog, one reader identifying herself as a social worker examines
the experiences of Annie in comparison to Alice Cullen, which I will examine later. This reader
looks at how Annie is described within the novels and thinks about how real world individuals
would interpret Annie's experience. She believes Annie represents an extreme of society and can
be used for clinical discussions. An example of this is the following two questions:
1. Annie is excessively medicated in District 13. What do you think about medical
management of peoples mental health problems? Does Annie need to do anything else?
2. If your teen responds with suggestions of therapy for Annie, discuss the pros of
therapy they’ve learned from their work with you =) (Socialwrkgirl).
These questions show that this reader is viewing Annie in much the same way that one
views her own patients. Perhaps for this reason, she makes a specific point of how Annie and
Finnick are able to get their happy ending (Socialwrkgirl).
Some readers view the ending as bittersweet. Within the discussion board above, KJ
admits that Katniss and Peeta's happily-ever-after is nearly miraculous given their past (“***Fan
Question*** Changing Mockingjay”). Another reader points out on a Tor.com blog how the
characters are never truly whole again after the traumatic situations they undergo. This is seen
when comparing Katniss to Haymitch. He provides a dark mirror to her experiences, although

46. both characters are heavily scarred (Kessock). Finally, on her blog, a third reader points out that
that they are disappointed by some of the events involving Katniss in Mockingjay, but they
acknowledge these events are an example of how life is not fair (Sunshine).
Regarding Peeta and Katniss, blogger BookingMama is glad Katniss is able to get her
happy ending even though it takes a long time. Within a discussion board, Rachel points out this
is a fairytale ending, but it is what many fans, including herself, want (“***Fan Question***
Changing Mockingjay”). In the same discussion, KJ, another reader, points out that given the
tragedy of the series it easily could have ended in a fashion similar to Romeo and Juliet. The
ending was happy in its normalcy (“***Fan Question*** Changing Mockingjay”). One
Amazon.com reviewer David Otoole identifies as a middle aged veteran. He says this book is a
realistic deception of how war and sacrifice can shape a person. He disagrees that the ending is a
“happily ever after” fairy tale ending, which would have been unrealistic; the ending is a as
happy as can be expected ending (Otoole). As Michelle D. another contributor to the discussion
board posted, “Unfortunately life isn’t clean, nor simple and it certainly isn’t wrapped up in a
chapter. There isn’t always a happy ending, and in this case I think it ended as happy as it could
given the amount of loss Katniss had to come to terms with” (“***Fan Question*** Changing
Mockingjay”). These readers all believe that Katniss has a happy ending. It may not be
immediate, but that does not mean that Katniss is not able to have a good life despite all she goes
through.23
Unlike in the case of New Moon, all of the readers highlighted above discuss the
experiences of the characters in The Hunger Games in a generally positive light. Despite the dark
nature of these novels, these prove to be stories of hope. This matches the ideas seen of young
adult novels as a whole. Each of the characters has a different experience, and even within

47. character, some readers may view things slightly differently. Regardless of this, readers view
these books as logical and positive stories.
Going Beyond the Novels: Illness Experiences
While the experiences of fictitious characters described as having with mental illness-like
symptoms or conditions can be interesting, the characters are simply elements of a narrative.
Readers, however, are people living in the real world. For that reason, I explore what social
science researchers have found through qualitative research about the experiences of people
living in the real world. This relies heavily upon the perceptions of individuals who deal with
mental illness, as patients, family members, healthcare professionals et cetera, as they generally
come from interviewing these individuals. Other times, however, researchers are actually able to
observe their subjects through ethnography.24 This research takes individual experiences of these
people and uses them to explain what it means to be a person with a mental illness in today's
world.
For many years, personal experience with mental illness was something that was not
publically talked about (Muhlbauer 87-9). Individuals dealing with mental illness as well as their
family and friends were alone in their experience. People became overwhelmed because they did
not know what to do and were unwilling to talk about these situations (Muhlbauer 82). In 2002,
Susan Muhlbauer published a study using semistructured and dramaturgical interviews to
interview twenty-six people who have family members with a mental illness to examine how
these family members are affected by and manage their family members' condition (76). Since
this study looked at the experiences of family members, who have dealt with their family
members conditions sometimes for years, it provides a look at how opinion has changed over

48. time. Furthermore, however, these interviews provide evidence into not only how the family
members interacted with their loved one’s diagnosis but how they believe the individuals with
mental illness to be treated. Some family members try to limit who they talk to about their loved
one's mental illnesses. They did not deny the conditions, yet they tried to limit the degrading or
devaluing information others had. The stigma of mental illness was as overwhelming for family
members as it was for the individuals themselves (Muhlbauer 78-9). The way that these family
members treated the diagnoses of their loved ones is similar to the way that Rose interacted with
Lissa's diagnosis at the end of Vampire Academy. She does not deny that Lissa receives
medication or therapy. She simply does not share this information that causes others to think
worse of her friend.
For some patients, hiding their condition is not an option, as the treatments physically
mark their patterns of behavior, showing others they were unable to function normally in society
(Herman 299-300; Camp et al 828). Janis Hunter Jenkins and Elizabeth A. Carpenter-Song
performed an ethnographic study at a community mental health center to see how the stigma
resulting from a diagnosis of schizophrenia affects individual’s day-to-day lives (Jenkins and
Carpenter-Song, “Awareness of Stigma Among Persons With Schizophrenia the Contexts of
Lived Experience” 520; Jenkins and Carpenter-Song, “Stigma Despite Recovery” 381). The data
from this study shows how individuals interact with their mental illness diagnoses on a day-to-
day basis, which is relevant since it has as much to say about one’s experiences as a study
looking at the overall picture. Even when individuals were able to recover and function
normally, they retained their identity as someone with schizophrenia (Jenkins and Carpenter-
Song, “Awareness of Stigma Among Persons With Schizophrenia the Contexts of Lived
Experience” 527; Jenkins and Carpenter-Song, “Stigma Despite Recovery” 386). This is similar

49. to how Katniss maintains her identity as a “Mentally Disoriented” person as she begins to
reintegrate herself into day-to-day life. While Katniss is able to ultimately use this to her
advantage, it easily could have gone the other way. I imagine that even if Annie were able to
later gain a sense of normalcy for her and her child she would always retain the label of “mad.”
Her behavior up to that point means she will always be viewed as different.
While there is still a focus on the negative aspects of the mental illness experience in
many articles, others seem to show that things are better than they once were. Jette Westerbeek
and Karen Mutsaers write, “Since about 1990, a growing scholarly literature (psychotherapy,
sociology, women’s studies, and literary studies) has examined the relationship between identity
and mental disturbance from the perspective of illness narratives by patients themselves or by
their psychotherapists. These publications focus on illness stories in moderate opposition to the
currently dominant biomedical argument” (27). Further, people have found that when they were
willing to be open about their experiences and the experiences of those around them, others were
willing to be accepting (Muhlbauer 82). In a study published in 1993 of interviews with former
psychiatric patients, one man reported that when they finally told their uncle, they found
acceptance as opposed to rejection. This person’s uncle helped them to accept that their mental
illness was simply another illness (Herman 312). This man highlights the idea that mental illness
is simply another type of illness that can be treated like any disease. This raises questions of
education and how one perceives their situation. People with depression may view themselves as
having simply another illness, although they may not be able to make this distinction during a
depressive episode (Karp 47). Additionally, these individuals want to be judged based on who
they were as opposed to solely their mental illness diagnosis (Wahl 477). This is similar to how
Bella does fail to acknowledge that there is anything particularly wrong with her for much of

50. New Moon.
While adolescence may seem the obvious link between all the novels, it is not the only
one. All of the series take part as least partially in rural areas. The experiences of people who live
in rural areas differ from those in the general population. In general, there are a number of
barriers between rural communities and mental health treatment including “stigma associated
with mental illness, shortage of health care providers, reluctance to acknowledge problems when
they exist, lack of family and community support, inadequate health insurance coverage, lack of
privacy, financial constraints, lack of transportation, and difficulty finding child-care among
others” (Robinson et al 308-9). W. David Robinson et al interviewed forty-four adult patients
and family members living in rural areas to examine these individuals' experiences (310). Like
others, these individuals were reluctant to discuss their mental illness diagnosis out of fear of
stigma. In these communities, people reported that those who were known to have mental
illnesses were viewed as weak (Robinson et al 311). Over time, these ideas clouded individuals’
perceptions preventing people from seeking help. Further, these communities deny the existence
of mental illness. Patients feel rejected as others choose to ignore their illness status. Some
patients reported that education may be a way to counter this effect at least among families
(Robinson et al 312).
This problem of visibility extended to medical professionals as well. The patients
believed primary care physicians were doing their best, yet they felt the doctors did not do
enough at times failing to recognize mental illness or going against the orders of psychiatrists
(Robinson et al 312-3). The two main factors that individuals mentioned as barriers against
specialist care were distance to care and cost (Robinson et al 313). Also, patients reported law
enforcement and the courts could be disadvantageous to getting help. If someone is going to be

51. escorted to the hospital in handcuffs by the police at the mention of symptoms of mental illness,
then they are unlikely to mention these symptoms (Robinson et al 314-5). This is made worse
when there is no psychiatric department at the local hospital and help is hours away (Robinson et
al 317). Overall, the participants of this study feel that there are issues which must be addressed
in order to make help more accessible for people living with mental illnesses in rural
communities.
While many readers of the books may not notice the rural setting, readers living in
communities similar to those in the novels may understand this aspect of the novels. While Bella
sees a doctor, it is unknown if it is a psychiatrist. Perhaps, if she was to receive treatment, she,
like the people above, would need to go to a different town. Bella and Charlie, who is chief of
police, probably find it easier to pretend that she is better than she really is. Further, others may
identify with Katniss after she is sent back to District 12. She is expected to continue with
treatment started in the Capitol, yet that is very far away. There are no “head doctors” closer.
In conclusion, the experiences of individuals with mental illness are varied depending on
any number of factors such as age and availability of care. Despite this, the overall picture may
be improving as the general view of some forms and severity levels of mental illness evolves
into one of an illness that can be treated, it leaves the possibility for someone to live a happy,
normal life. While other factors as listed above, such as ability to hide one's condition,
accessibility of treatment, or support from others, shape what these lives can look like, one can
achieve a “happy ending.” As with the novels, individual's experiences are not cookie cutter.
There is variation in how the ending is reached and what it entails.
Recovery
All of the books display some kind of happy ending for the characters mainly because the

52. characters display some level of recovery from their mental illness-like states. If Bella was still
recklessly seeking out the next thrill, it would not be long until she harmed herself beyond
recovery. The same could hold true for Lissa and her cutting, and if Katniss were still locked
into her trauma and seeking peace in closets, she would be not be able to develop as a character
beyond where she was in the bulk of Mockingjay. These statements along with the way these
stories end show the complexity of the term recovery, which can be interpreted in different
ways, and depending upon how one looks at a situation, the ideas may be present without the use
of the word recovery.
The first way in which recovery can be defined is in a clinical sense. Recovery is
synonymous with cure (Slade et al qtd in Castillo et al). In this way, Bella has recovered from
her depression-like state because after reuniting with Edward, she no longer displays her
depression-like symptoms. For many, however, this idea of a cure is an impossible goal.
Expecting this form of recovery can create a burden upon individuals for whom this is
impossible (Castillo et al). Because the first definition of recovery is inappropriate for many with
mental illness, alternated ways of approaching the term recovery emerged.
Building upon this model, one interdisciplinary team of researchers examining recovery
in mental illness borrow from psychiatric rehabilitation literature stating one of the main ways of
looking at mental illness is in terms of restoring functioning (Hess et al, "Is There a Getting
Better From This, or Not?"). This idea may appear similar to the clinical ideas of recovery, but it
does not necessarily require the absence of disorder. It holds that with the correct support one
can regain a sense of normality despite the chronic nature of mental illness and relies heavily
upon the ideas of managing one's illness. One father embodies this idea in saying, “How can we
help her confront this illness, deal with it, manage her illness so as to enable her to realize the best

53. objectives that she can reach given her disabilities – i.e., living life as a disabled person?" (Hess et
al, "Is There a Getting Better From This, or Not?"). While the father changes his perspective later,
at this point, he fulfilled the idea of restoring functioning (Hess et al, "Is There a Getting Better
From This, or Not?"). This father believed that if they could simply find the right strategy, his
daughter would be able to succeed. This idea of illness management is reminiscent of Lissa's
experience. By taking medication and going to therapy, she is able to live the same life she
would be able to otherwise. While this is a form of recovery, it is still limited.
In contrast, from within narratives of those utilizing community psychiatric facilities, the
idea of recovery evolved into one of living beyond one's illness. This definition uses the ideas of
hope and opportunity to make the best life possible (Castillo et al; Davidson qtd in Castillo et
al). The above mentioned team of researchers identified deepening wellness as the other aspect
that went into a definition of recovery. As opposed to above where the focus is on symptoms,
this aspect focuses upon the whole person's state of being. For example, one woman defined
recovery as being able to not only accept that one cannot be able to be happy all the time but
also truly be happy when the time allows (Hess et al, "Is There a Getting Better From This, or
Not?"). Since this is a more open-ended definition of recovery, it allows for different people to
define recovery according to the standards of their condition and their lives. This is the idea of
recovery that is seen with Katniss and Peeta. While many readers do not believe they have
recovered, they seem to have shaped their lives into what they want. They identify that their
symptoms will never completely go away, but they do not prevent this from allowing them to
live full lives. Hess et al highlight the importance of being flexible in what recovery will look
like especially in children and adolescents who still have long lives ahead of them.

54. The example of Katniss and Peeta highlights the importance of allowing individuals to
define their own sense of recovery. Social workers Castillo et al point out that it is assumed that
service providers work with clients to client-centered goals. However, when these goals are set
by the provider, then the goals may not be in line with the clients’ mindset (Castillo et al). When
recovery is defined in terms of illness management or cure, then it can lead to patients and their
families believing that recovery is not possible (Hess et al, "Is There a Getting Better From This,
or Not?"; Castillo et al). If someone has been told they will spend their entire life on medicine,
then it may be they believe a full recovery is not possible (Hess et al, “Is There a Getting Better
From This, or Not.”). Castillo et al therefore worked with clients with personality disorders
receiving services at a facility blending crisis management and community therapeutic principles
to see how the clients defined recovery. The resulting hierarchy is something that is unique to
individuals in this specific circumstance, but it can provide light to how recovery should be
treated. Clients defined their recovery journey in terms that begins with developing a sense of
safety and building trust and advances through feeling cared for; a sense of belonging and
community; learning the boundaries; containing experiences and developing skills; hopes,
dreams and goals; and achievements before finally reaching transitional recovery (Castillo et al).
This recovery begins with a safe space and allows the individuals to grow beyond it in terms that
no one would otherwise define when discussing recovery since the language and goals are set by
the clients at the center. This hierarchy allows that where one is on their recovery journey
changes over time. This is important because as a part of recovery people may need to change
their personal trajectory (Hess et al, "Is There a Getting Better From This, or Not?"). The
hierarchy allows for people to focus on different stages as they move their way up the hierarchy.
While others may have similar ideas, by letting the clients define recovery in their own way, it