Anxious? Stressed? Express it in Writing
Ask anyone to make a list of the treatments recommended for anxiety, stress or trauma and they are most likely to mention medication, counseling and maybe relaxation. Those more in the know will point to diet, exercise, good sleep, reduction of stressors and techniques to improve or maintain personal resilience. All good stuff, but I suspect comparatively few would add writing about emotional experiences to their list. Despite this, and for the past 20 years or so, a variety of studies have pointed to significant physical and mental health improvements when people use writing as a therapeutic tool.
Dr. James W. Pennebaker, a professor of psychology at the University of Texas, is one of the leading figures in the development of the method. Pennebaker and his colleagues first noticed that many of the scales devised to measure the effects of stress on people's health tended to focus on socially acceptable issues (death of a spouse, loss of a job) and avoided more sensitive areas such as rape, being the victim of violence, causing the death of others, etc. It also became clear that people who kept silent about personal traumas were significantly more likely to suffer adverse health effects. This prompted Pennebaker to test whether writing, as a form of disclosure, might be beneficial.
Initial research, conducted by Pennebaker and Beale in 1986, was promising. People were simply asked to write for 15 minutes a day over a period of four days about a trauma. They discovered that the simple act of writing appeared to tap into deep personal emotions which in turn resulted in a reduction of visits to the doctor, reduced self-medication and a positive evaluation of the writing experience.
Since publishing these early findings a whole series of investigations have been conducted with varying findings. In just two examples, one study found that writing or talking about emotions has been found to positively influence immune function and reduce blood pressure. A second suggests that writing by hand seems to be more beneficial than typing possibly because the act of writing is slower and encourages deeper reflexion.
To date there appears to be no consensus as to whether an optimal time exists after trauma for expressive writing to be most effective. Some have suggested therapy within a 72 hour window of trauma, but studies suggest this may cause more harm than benefits.
As to why expressive writing appears to have beneficial effects it seems clear that this is unclear! No single reason explains its effectiveness but some ideas have been put forward that may have some bearing. One suggestion is that people are more likely to inhibit thoughts and feelings viewed as socially threatening (e.g. rape). It follows that by offering a method that enables disclosure, this will result in greater health improvements. Simply documenting the details of the trauma in a detached fashion does not lead to any improvement. An essential component is emotional engagement. Another possible explanation comes from the principles of learned association. Repeated exposure to emotional stimuli will eventually break the link between an event and the person's emotional reaction to it. So writing provides the vehicle through which these negative ties might be broken.
Pennebaker, J.W. (1997) Writing About Emotional Experiences as a Therapeutic Process. Psychological Science. Vol 8. 3. 162-166
Pennebaker, J.W., & Seagal, J.D. (1999) Forming a Story: The Health Benefits of Narrative. Journal of Clinical Psychology 55 (10) 1243-1254.
Pennebaker, J.W., & Chung, C.K. (2007) Expressive Writing, Emotional Upheavals, and Health. In H. Friedman and R.Silver (Eds), Handbook of Health Psychology (pp. 263-284). New York: Oxford University Press.