The humble combination of paper and pencil has proven to be a promising treatment for mental health issues in psychological research. Expressive writing, therapeutic writing, or script therapy are some of the names for the same principle: writing as a therapeutic process. How is it possible that something as ordinary as briefly writing in a journal or making similar notes can bring relief from distressing mental states and physical symptoms, or even boost immunity?
James Pennebaker and Sandra Beall were at the forefront of research into therapeutic writing. In 1986, these psychologists assigned students a rather unpleasant task: “Write continuously about the most disturbing event you have ever experienced. You can write about anything. But whatever you choose, it should be something that has deeply affected you. Ideally, something you haven’t really confided in anyone about before.” Without worrying about grammar or sentence structure, the students were tasked with trying to tap into their deepest emotions and thoughts surrounding the traumatic event in question.
To control for the possibility that this was simply the beneficial effect of writing in general, half of the participants were instructed to describe boring, everyday matters (such as their rooms or a pair of shoes). The results for the experimental group were promising: although the act of writing itself was followed by a short-term decline in mood and an increase in blood pressure, in the long term these students reported an improvement in their overall health and fewer reasons to visit a doctor.
And that’s not all—80% of them, in a questionnaire completed several months after the experiment, described their experience as very beneficial. The students saw the main benefit as being that, by writing about unpleasant experiences, they were able to gain a better understanding of themselves. “Although I hadn’t talked to anyone before about what I was writing about, I was finally able to deal with it, to come to terms with that pain instead of trying to ignore it,” said one of the students: “it doesn’t hurt to think about it anymore.” Others described their experiences similarly—for one participant, the experiment “helped me think about what I felt back then. Until then, I had never realized how much it had affected me. I had to reflect on and come to terms with past events.”
Other studies have confirmed the same—for example, in this one, which is more recent and very similar to the original experiment, participants were tasked with writing briefly (15–20 minutes, three to five times in total) to write about a traumatic experience—as a result of which they were then healthier both mentally and physically compared to those who wrote about neutral events.
Given the therapeutic potential of expressive writing, research has not been “wasted” solely on populations of (predominantly) healthy college students. Psychologists S. Mugerwa and D. Holden published a comprehensive list of studies that confirmed the positive impact of expressive writing on a wide variety of health conditions—such as irritable bowel syndrome, rheumatoid arthritis, depression, and anxiety, post-traumatic stress disorder; it has also brought relief to patients diagnosed with cancer or asthma. These findings served as the foundation for therapeutic approaches such as cognitive-behavioral writing therapy (cognitive-behavioral writing therapy) or methods such as therapeutic journalsthat are used in clinical practice, for example in the treatment of PTSD or addiction. “Mental health journals can help a person connect their feelings to actions and events, and assist in sharing painful experiences rather than internalizing them”, write Alexander, McAllister, and Brien. Research, for example, has confirmed that encouraging self-reflection (through journaling and feedback on those entries) had a positive effect on treatment progress among psychiatric patients.
The truth is that there are and studiesthat found no link between therapeutic writing and improved health. However, we will have to wait for a final verdict on the ineffectiveness or effectiveness of writing as a therapeutic tool —the current body of evidence “against” it does not yet outweigh the studies and personal testimonies highlighting the benefits of this method. Caution is warranted here as well—“the initial anxiety caused by writing may be too intense for some people, especially if they lack emotional support”, write Mugerwa and Holden, emphasizing that if, while writing, a person finds themselves in an overly distressing or serious state, they can, of course, stop at any time and, if necessary, seek professional help. A large proportion of people, as a result of reflecting on unpleasant experiences, do indeed encounter “an immediate increase in short-term distress and negative affect”, but this “is not harmful in the long term”; this discomfort will soon pass, replaced by relief from both mental and physical distress.
It is clear that various types of therapeutic writing can be useful both in combination with traditional psychotherapy and as a form of self-treatment or self-help. “If we talk or write about the source of our problems without engaging in self-reflection, we only make our stress worse,” write Pennebaker and Smyth. It is important not to slip into merely “pouring out one’s heart” without reflecting on the events described, the circumstances, and the feelings surrounding them. Ask yourself: “Why am I writing this way? What feelings does this evoke in me? Why does this person (…this event, whatever)bother me so much?”
If you’re in the mood to experiment or deepen your self-awareness, you can try expressive writing for yourself—all you need is to take out your writing materials for a moment during a quiet time on a few consecutive days; you can follow the instructions taken from the book by the pioneers of expressive writing, Pennebaker & Smyth— Opening Up by Writing It Down:
“For the following writing exercise, find a quiet place and some time. Write for 20–30 minutes, focusing on your deepest emotions and thoughts regarding a stressful or troubling event you have experienced. Whatever topic you choose to write about, it’s essential that you really let things out and set out to explore your deepest emotions and thoughts. Write continuously; don’t worry about spelling, grammar, or style.
Warning: Many people experience a sense of sadness as a result of writing, but this usually passes within a few hours. If you notice extreme distress caused by what you’re writing about, simply stop writing or choose a different topic.”
And… how does this all actually work? More on why writing helps in the next article.
