This article presents a heuristic research project designed to explore the role of personal writing in the development of the self. True to the heuristic process as outlined by Moustakas, the author analyzed over 30 years of personal poetry and journal writing through her mother’s mental illness and brother’s traumatic brain injury and epilepsy. Phase two of the project included nine participants (co-researchers) who were lifetime writers. Results indicated themes related to the (i) interpersonal and personal nature of writing, (ii) the spiritually transcendent nature of writing, (iii) the fact that writing facilitates perspective taking, (iv) the importance of challenge in personal growth, (v) the dynamic nature of writing, and (vi) the power of writing to influence personal identity. The paper presents the process, stories of the author and three participants, synthesized results, the power of the heuristic process, and potential application to the creative arts.
Eur J Psychotraumatol. 2014 Dec 22;5:24917. doi: 10.3402/ejpt.v5.24917. eCollection 2014.
Treatments for adolescents affected by long-term loss in low- and middle-income countries are lacking. As school-based interventions are cost-efficient and easy to disseminate, an evaluation of this treatment setting for adolescents is worthwhile.
Examining the effect of a school-based unstructured emotional writing intervention (sensu Pennebaker, group 1) about the loss of a parent to reduce adaptation problems to loss, compared to writing about a hobby (group 2), and non-writing (group 3).
We randomly assigned 14-18-year-old Rwandan orphans to one of the three conditions (n=23 per condition). Before and after the intervention, subjects completed the Prolonged Grief Questionnaire for Adolescents and the Mini International Neuropsychiatric Interview for Children and Adolescents, Part A, on depression as self-report measures of long-term effects of early parental loss.
Repeated measures analyses of variance showed no differential effect for any of the three conditions but revealed a significant effect of time at posttest regarding grief severity. Reduction of grief symptoms was significantly higher in subjects with elevated grief. Depressive symptoms showed no significant change from pre- to posttest in the emotional writing condition, whereas they significantly decreased in the control condition.
RESULTS imply that unstructured, brief emotional writing might not be indicated in adolescents affected by early parental loss who show severe and long-term distress; a more structured approach seems recommendable.
Expressive writing (EW) can be a useful supplement to psychotherapy, regardless of therapeutic orientation. In an open trial of exposure-based cognitive therapy for depression, 43 participants used EW before each session, producing 928 EW samples. Using examples from these, we discuss how EW can be used to both promote and track therapeutic change. Specifically, we review the impact of EW on therapeutic growth, via self-monitoring, increased awareness, and exposure/emotional processing. We then discuss how EW can be used to track important predictors of change such as symptoms, therapeutic alliance, social support, avoidance, and hopelessness. We conclude by discussing potential limitations to the use of EW in therapy and by recommending specific strategies for incorporating EW into clinical practice.
Year: 2014 Issue: 6
Journal: Chinese Journal of Clinical Psychology
Keyword: Stress; Expressive writing; Cortisol; Posttraumatic growth; Psychological intervention;
Abstract: Objective: To examine the effect of short term expression writing on stress response in laboratory condition.Methods: 64 4th grade clinical medical students were randomly divided into intervention group and control group. Stress responses were induced by videoes doctor-patient conflicts. After that, state anxiety, negative emotion(such as anger, anxiety, depression and fear), salivary cortisol and posttraumatic growth were assessed. 15 minutes expressive writings included feeling and ideas, express emotion and search for resources and support about stress event was used as the intervention method in writing group for 3 times. The subjects of control group took uninvolved writing. Results: The conflict video induced obvious stress response of subjects, the levels of state anxiety, anger, anxiety, depression and fear scores after video show were significantly higher than that at the baseline in both groups(P<0.01). Both expressive and uninvolved writing significantly decreased the levels of state anxiety, anger, anxiety and fear(P<0.01), but had no effects on depression scores(P>0.05). Compared with control group, expressive writing group had lower levels of anxiety and anger(P<0.01; P<0.05). Expressive writing had no significant effect on salivary cortisol level and posttraumatic growth(P>0.05). Trait anxiety had positive correlation with state anxiety, anxiety, depression and fear(P<0.001) just after stress-induction, and had positive correlation with state anxiety and depression after intervention(P<0.001). Gender(female) had positive association with state anxiety, depression and fear after stress(P<0.001; P<0.005). Conclusion: Short term expressive writing significantly can decrease stress reactions effciently.
Published online 2013 Dec 23. doi: 10.1080/10615806.2013.868887
Standard written emotional disclosure (WED) about stress, which is private and unguided, yields small health benefits. The effect of providing individualized guidance to writers may enhance WED, but has not been tested. This trial of computer-based WED compared two novel therapist-guided forms of WED—advance guidance (before sessions) or real-time guidance (during sessions, through instant messaging)—to both standard WED and control writing; it also tested Big 5 personality traits as moderators of guided WED. Young adult participants (n = 163) with unresolved stressful experiences were randomized to conditions, had three, 30-min computer-based writing sessions, and were reassessed 6 weeks later. Contrary to hypotheses, real-time guidance WED had poorer outcomes than the other conditions on several measures, and advance guidance WED also showed some poorer outcomes. Moderator analyses revealed that participants with low baseline agreeableness, low extraversion, or high conscientiousness had relatively poor responses to guidance. We conclude that providing guidance for WED, especially in real-time, may interfere with emotional processing of unresolved stress, particularly for people whose personalities have poor fit with this interactive form of WED.
J Clin Oncol. 2014 Mar 1;32(7):663-70. doi: 10.1200/JCO.2013.50.3532. Epub 2014 Jan 27.
This randomized controlled trial examined the quality-of-life benefits of an expressive writing (EW) intervention for patients with renal cell carcinoma (RCC) and identified a potential underlying mechanism of intervention efficacy.
PATIENTS AND METHODS:
Patients (N = 277) with stage I to IV RCC were randomly assigned to write about their deepest thoughts and feelings regarding their cancer (EW) or about neutral topics (neutral writing [NW]) on four separate occasions. Patients completed the Center for Epidemiologic Studies Depression Scale (CES-D), MD Anderson Symptom Inventory (MDASI), Brief Fatigue Inventory (BFI), Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Short Form-36 (SF-36), and Impact of Event Scale (IES) at baseline and 1, 4, and 10 months after the intervention.
The mean age of participants (28% stage IV; 41% female) was 58 years. Multilevel modeling analyses, using a Bonferroni-corrected α = .021 for six outcomes adjusted for the correlation among outcomes, revealed that, relative to the NW group, patients in the EW group reported significantly lower MDASI scores (P = .003) and higher physical component summary scores on the SF-36 (P = .019) at 10 months after the intervention. Mediation analyses revealed that significant group differences for MDASI scores at 10 months were mediated by lower IES scores at 1 month after the intervention in the EW group (P = .042). No significant group differences were observed in the BFI, CES-D, PSQI, and mental component summary of the SF-36.
EW may reduce cancer-related symptoms and improve physical functioning in patients with RCC. Evidence suggests that this effect may occur through short-term improvements in cognitive processing.