Q: Can writing improve your health?

There is a form of writing which has been shown to have remarkable effects on research subjects’ well-being, social functioning, and cognitive abilities. The best-known of the scientists who study ‘expressive writing’ is James W. Pennebaker, chair of the Department of Psychology at the University of Texas. Pennebaker and several others around the world have found that a short series brief exercises of this particular form of writing about emotional upheavals can improve physical and mental health.

An early study

In his accessible book Opening Up: The Healing Power of Expressing Emotions (free chapter here) Pennebaker describes an early experiment. Fifty students were asked to write for 20 minutes a day for four consecutive days. Half were to write about superficial matters; the other half about a traumatic event. Blood was drawn the day before writing commenced, after the final session, and six weeks later. Results. 1. Compared to the superficial writers, the students who wrote about trauma reported feeling sadder and more upset after each day’s writing. 2. Those who wrote about trauma had improved immune function (T-lymphocytes). This was highest the last writing session, but persisted for six weeks. 3. The number of visits to the health centre dropped among those who wrote about trauma. (See below for other effects found in subsequent studies.)

This is likely to seem to be a claim of magic, so let’s go back a step. “Having any type of traumatic experience is associated with elevated illness rates; having any trauma and not talking about it further elevates the risk.” Many readers of Lovefraud have testified to this; they name multiple instances of physical and mental ailments which they date to their stressful and traumatic relationships with psychopaths. And they describe multiple ways of working through it all including participating in internet sites like this one. If non-expression is bad for one, expression might conceivably be good – but exactly what kind of expression matters enormously.

The method

Writing about emotional upheavals in our lives can improve physical and mental health. Although the scientific research surrounding the value of expressive writing is still in the early phases, there are some approaches to writing that have been found to be helpful. Keep in mind that there are probably a thousand ways to write that may be beneficial to you. Think of these as rough guidelines rather than Truth. Indeed, in your own writing, experiment on your own and see what works best.

Getting Ready to Write
Find a time and place where you won?t be disturbed. Ideally, pick a time at the end of your workday or before you go to bed.”¨”¨Promise yourself that you will write for a minimum of 15 minutes a day for at least 3 or 4 consecutive days.”¨”¨Once you begin writing, write continuously. Don’t worry about spelling or grammar. If you run out of things to write about, just repeat what you have already written.”¨”¨You can write longhand or you can type on a computer. If you are unable to write, you can also talk into a tape recorder.”¨”¨You can write about the same thing on all 3-4 days of writing or you can write about something different each day. It is entirely up to you.”¨”¨

What to Write About
Something that you are thinking or worrying about too much.
Something that you are dreaming about.
Something that you feel is affecting your life in an unhealthy way.
Something that you have been avoiding for days, weeks, or years.

Researchers have found which aspects of this writing are vital and which can be varied – and by how much.

• ‘Writing’ – It turns out that writing with pen and paper, typing on a keyboard, and even ‘writing’ without marking the page (e.g. with the nib retracted) each work fine. (Indeed, female participants do better with the latter method in that they feel freer to use curse words). Even speaking (in this free-form way) into a dictaphone while in bed helped participants to sleep. Importantly, thinking about the trauma showed none of the benefits – some form of expression is crucial.
• Free expression – While the mechanics of the expression can vary, the form of the expression should not. The writing must be ‘free’ – continuous, unencumbered, uncensored. It is helpful to write with the intention of destroying the pages afterwards – if no-one, not even oneself is to read them one may feel more able to let go.
• Frequency – Once a day on three consecutive days was as effective as once an hour for three consecutive hours all on one day. The crucial factors are the regularity (no more than 24 hr gaps) and a frequency of no less than three and no more than four sessions.
• Duration – Writing sessions of not shorter than 15 minutes and not longer than 20 minutes work fine.

Some important Don’ts

• Don’t do too soon after a trauma – It is very important to let one’s normal adaptive mechanisms (including rumination and obsessing) do their healing work. In other words, it is completely normal and even necessary to struggle somewhat after experiencing trauma or emotional upheaval. Only if the symptoms persist after 3-6 months might something like expressive writing be called for.
• Don’t do for more than four days – this particular form of writing, says Pennebaker, shouldn’t be used in an ongoing fashion. It takes one down emotionally at first – one’s system must be given a chance to pick up again.
• Don’t do if it seems too much to tackle – Expressive writing is meant to help not hurt.
• “Despite the large number of promising studies, expressive writing is not a panacea.” — Pennebaker and Chung
• Disclaimer – You will appreciate that I am not in a position to give psychological or medical advice in this forum. This post is not a recommendation but rather food for thought. If it makes sense to you, please discuss it with a mental health professional.

Write unhappy, think happy

The magazine Scientific American Mind summarises the field of expressive writing. It refers to a study which tested three forms of retelling an experience: telling it or writing it proved therapeutic, merely thinking about it, though, “created chaos: events, images and emotions became intertwined, leading people to relive the experience – with the danger of becoming lost in the misery all over again.” (I have referred to this phenomenon as rumination.)

It is noteworthy that ruminating about happy or good things makes one happier (ruminating about unpleasant things, as we’ve seen, is bad for one); conversely, writing about happy things somewhat spoils them (while writing about unhappy things is therapeutic). Note: this refers only to free-form writing.

Any comments? I’d love to hear them.

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Some other research findings

Here are some illustrative points from a 2007 review of the field by Pennebaker and Chung:

• significant drops in physician visits among relatively healthy samples
• beneficial influence on immune function in beneficial ways, including t-helper cell growth (using a blastogenesis procedure with the mitogen PHA), antibody response to Epstein-Barr virus, and antibody response to hepatitis B vaccinations
• skin conductance levels are significantly lower during the trauma disclosures
• systolic blood pressure and heart rate drops to levels below baseline following the disclosure of traumatic topics but not superficial ones

In short, when individuals talk or write about deeply personal topics, their immediate biological responses are congruent with those seen among people attempting to relax. McGuire, Greenberg, and Gevirtz (2005) have shown that these effects can carry over to the longterm in participants with elevated blood pressure. One month after writing, those who participated in the emotional disclosure condition exhibited lower systolic and diastolic blood pressure (DBP) than before writing. Four months after writing, DBP remained lower than baseline levels.

• attitude, stereotyping, creativity, working memory, motivation, life satisfaction, and school performance all changed for the better
• students who write about emotional topics evidence improvements in grades in the months following the study
• senior professionals who have been laid off from their jobs get new jobs more quickly after writing
• university staff members who write about emotional topics are subsequently absent from their work at lower rates than controls
• self reports also suggest that writing about upsetting experiences, although painful in the
  days of writing, produces long-term improvements in mood and indicators of well-being
  compared to controls