In this article, a model of transformation-through-writing will be introduced that helps to explain how a transformative and dialogical-learning process occurs when narratives or poetry are used for healing. We focus in particular on how a “boundary experience” is processed—or how a painful “first story” can be rewritten to become a more life-giving “second story.” We propose that this occurs stepwise in four cognitive stages: sensing; sifting; focusing; and understanding. These stages are explained and underpinned by research on neurobiology, neuropsychology, and on identity learning. The case study used to illustrate this process, focuses on expressive and reflective writing in emotional recovery from domestic violence. To be effective, therapeutic writing requires a safe and enriching learning environment; we discuss how such an environment supports the dialogical self and what considerations a facilitator might take into account when working with a student or client.
Patient Prefer Adherence. 2011 Jan 6;5:15-21. doi: 10.2147/PPA.S15155.
This paper, the second of two, reports the results of a systematic writing program used as a tool in the grief process. The study was based on a specifically developed program, which has been described and discussed previously in Part 1.
The study had a qualitative research design, with a hermeneutic phenomenological approach. The research tool of the study, a writing program, was developed and implemented. A purposive sample was used, consisting of 13 bereaved adults.
From an analysis of all of the texts written during the program, we drew four conclusions. Writing yields new thoughts and increases knowledge. Writing is stressful as well as a relief. Writing awakens and preserves memories. The value of writing is related to the forms, ways, and situations of writing.
We have discussed handling grief with a unique process. Our findings reveal a great breadth and variation in the experiences associated with different writing forms, ways of writing, and writing situations. This implies that flexibility and individualization are important when implementing grief management programs like this. We believe that a structured writing program can be helpful in promoting thought activity and as a tool to gain increased coherence and understanding of the grief process. This writing program may be a valuable guide for program development and future research.
Transl Behav Med. 2012 Mar;2(1):73-81. doi: 10.1007/s13142-011-0085-4.
Life stress and the avoidance of negative emotions may contribute to chronic pain. The technique of written or spoken emotional disclosure can reverse emotional avoidance and improve health, and 18 randomized studies have tested it among people with chronic pain. We review these studies to provide guidance for the clinical use of this technique. The benefits of emotional disclosure for chronic pain are quite modest overall. Studies in rheumatoid arthritis show very limited effects, but two studies in fibromyalgia suggest that disclosure may be beneficial. Effects in other populations (headaches, cancer pain, pelvic pain, abdominal pain) are mixed. Moderator findings suggest that some patients are more likely to benefit than others. Emotional disclosure has been tested in well-controlled efficacy trials, leaving many unanswered questions related to translating this technique to practice. Issues needing further study include determining disclosure’s effects outside of randomized controlled trials, identifying the optimal pain populations and specific individuals to target for disclosure, presenting a valid rationale for disclosure, selecting the location and method of disclosure, and choosing between cognitive-behavioral or emotional disclosure techniques.
Br J Health Psychol. 2008 Feb;13(Pt 1):27-30. doi: 10.1348/135910707X250929.
Manipulations of the setting and instructions were tested for effects on language use and reported health following expressive writing (EW).
Participants (N=76) wrote in one of three conditions that differed by setting and the delivery of writing instructions.
The results showed that altering the context for EW influences participants’ language use and their perceptions of the experience. There was no effect of conditions on self-reported health.
Future research should attend to the ways in which manipulations of EW context affect proposed mediators such as language, as well as outcomes of EW.