Although writing about traumatic events has been shown to produce a variety of health benefits, little is known about how writing produces benefits. The degree to which individuals form narrative structure when writing may predict health improvements. This study manipulated narrative formation during writing to test if narrative structure is necessary for writing to be beneficial. A total of 116 healthy students were randomly assigned to write about control topics or about their thoughts and feelings regarding the most traumatic event of their life in one of two ways: list in an fragmented format or construct a narrative. Individuals asked to form a narrative reported less restriction of activity because of illness and showed higher avoidant thinking than the other groups. The fragmented writing group did not differ from controls on any measure. These data (a) demonstrate that instructions to form a narrative produce a different response to writing than instructions to form fragmented and control writing and (b) suggest narrative formation may be required to achieve health benefits.