Emotional disclosure through writing or speaking modulates latent Epstein-Barr virus antibody titers.

J Consult Clin Psychol. 1994 Feb;62(1):130-40.

Esterling BA1, Antoni MH, Fletcher MA, Margulies S, Schneiderman N.

Healthy Epstein-Barr virus (EBV) seropositive undergraduates (N = 57) completed a personality inventory, provided blood samples, and were randomly assigned to write or talk about stressful events, or to write about trivial events, during three weekly 20-min sessions, after which they provided a final blood sample. Individuals assigned to the verbal/stressful condition had significantly lower EBV antibody titers (suggesting better cellular immune control over the latent virus) after the intervention than those in the written/stressful group, who had significantly lower values than those in the written/trivial control group. Subjects assigned to the written/stressful condition expressed more negative emotional words than the verbal/stressful and control groups and more positive emotional words than the verbal/stressful group at each time point. The verbal/stressful group expressed more negative emotional words compared with the control group at baseline. Content analysis indicated that the verbal/stressful group achieved the greatest improvements in cognitive change, self-esteem, and adaptive coping strategies.


A pilot study on the effects and feasibility of compassion-focused expressive writing in Day Hospice patients.

Palliat Support Care. 2012 Jun;10(2):115-22. doi: 10.1017/S1478951512000181.

Imrie S1, Troop NA1.

Research has found that writing about stress can confer physical and psychological health benefits on participants and that adopting a self-compassionate stance may have additional benefits. This pilot study evaluated a self-compassionate expressive writing intervention in a Day Hospice setting.


Thirteen patients with life-limiting illnesses wrote on two occasions about recent stressful experiences. Half also received a self-compassion instruction for their writing. Outcome measures were taken at baseline and one week after the second writing session, and text analysis was used to identify changes in the types of words used, reflecting changes in psychological processes.


Patients given the self-compassion instruction increased in their self-soothing and self-esteem in contrast to patients in the stress-only condition. Happiness broadly increased in both groups although reported levels of stress generally increased in patients given the self-compassion instruction but decreased in patients in the stress-only condition. Those given the self-compassion instruction also increased in their use of causal reasoning words across the two writing sessions compared with those in the stress-only condition.


Expressive writing appears to be beneficial in patients at a hospice and was viewed as valuable by participants. The inclusion of a self-compassion instruction may have additional benefits and a discussion of the feasibility of implementing expressive writing sessions in a Day Hospice is offered.



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The purpose of the present study was twofold: The first objective of this study was to investigate the relationships between self-compassion, self-esteem, body esteem, and body comparison; the second objective was to test the effectiveness of an expressive writing intervention for fostering self-compassion and positive body esteem. Part 1 of this study included a diverse sample of 299 graduate and undergraduate students (98 Male, 201 Female) from a large southwestern university. Results indicated that higher levels of self-compassion, self-esteem, and body esteem are positively correlated, and all negatively correlated with frequency of body comparison. Additionally, results suggest that self-esteem may account for the correlations between self-compassion and body esteem, and self-compassion and body comparison, indicating body esteem and body comparison may be subsumed under the broader definition of self-esteem. This finding warrants an exploration of body attitudes that relate to self-compassion. A new concept – body compassion – is introduced, which would incorporate dimensions of self- compassion into one’s perception of body. Women reported lower body esteem and a higher frequency of body comparison than men did. Women reported higher levels of common humanity as well. Further, age and education level differences, indicated that younger participants and those earlier in their college career experienced lower levels of self-compassion and self-esteem, and a higher frequency of body comparisons than older cohorts. Of those 299 participants, 28 completed part 2 of the study and were randomly assigned to either a Best Possible Self (BPS) writing topic condition or a control writing topic. Measures were administered after three days of writing and at 6-10 weeks later. Self-compassion, body esteem, and body comparison were not improved through this method of writing. However, self-esteem was found to have increased significantly after writing, suggesting that writing about one’s Best Possible Self may be an effective means of increasing self-esteem. Limitations of the study and directions for future research are discussed.