Integrating narrative/poetic content with the professional literature relating to trauma, the author explored how writing poetry contributed to her recovery and growth following the murder of her sister. It was concluded that writing poetry helped to reduce internal conflict and restore psychological balance. Metaphors and symbols enabled the exploration of the author’s response to trauma, which in turn led to recovery and growth.
Previous research suggests that writing about stressful experiences results in better health and psychological well-being. In the present study, a multi-ethnic sample of 79 HIV-positive women and men participated in a structured interview, and wrote about either their deepest thoughts and feelings about living with HIV (expressive writing) or their activities in the last 24 hr (control). Sixty-two participants returned for the 2-month follow-up and 50 returned for the 6-month follow-up interview. Oral fluid samples of beta2-microglobulin were taken at the baseline and follow-up assessments to examine the immunological effects of writing. No effects of writing condition were found, but expressive writing participants who included increasing insight/causation and social words in their writing had better immune function and reported more positive changes at follow-up. Results suggest that cognitive processing and changes in social interactions may be critical to the benefits of writing.
Expressive writing is a therapeutic intervention requiring individuals to write about distressing events and their emotional responses to these experiences (Pennebaker & Beall, 1986). The use of expressive writing has improved behavioural, physiological, and psychological outcomes in many populations, including individuals with posttraumatic stress disorder (PTSD; Baikie & Wilhelm, 2005). Greater self-disclosure on such writing tasks has been associated with higher perceived benefits and helpfulness (Brewin & Lennard, 1999). Researchers have investigated how expressive writing protocols can be utilized online to increase levels of self-disclosure when writing about traumatic experiences and, consequently, improve PTSD symptom outcomes. Researchers have not yet assessed for modality-based differences (e.g., typed vs. hand-written expressive writing) for therapeutic efficacy or emotional engagement. The present investigation examined whether 1) typed and hand-written expressive writing equally reduced PTSD symptoms; and 2) emotional engagement affected the efficacy of expressive writing in reducing PTSD symptoms. A community and student sample (n = 29) with clinically significant PTSD symptoms completed the trial. Participants were randomized to one of four conditions with different writing modalities (i.e., typed or hand-written) and paradigms (i.e., control or expressive writing). In one session, participants were administered three 15-minute writing tasks and self-report questionnaires evaluating aspects of emotion (i.e., recognition, expression, trait negative emotionality) and PTSD symptom severity. An optional 7-day follow-up questionnaire re-evaluating PTSD symptom severity was also administered to participants. Each experimental group had non-significant decreases in PTSD symptoms from pre- to post-intervention, these
changes being dependant on pre-intervention symptom severity; however, alexithymia, i
dissociation (i.e., attentional dissociation and dissociative amnesia), negative affect, emotional approach coping, and the presence of a learning disability did affect symptom changes, and when these factors were considered the experimental conditions significantly differed in their effect on symptom outcomes. In conclusion, findings of the current trial suggest that a day-intensive session of expressive writing neither reduces PTSD symptoms nor differs in efficacy based on its method of completion unless emotional engagement with the task is considered. Further investigation into how learning disabilities and emotional predispositions affect engagement with expressive writing is warranted to clarify its efficacy in clinical PTSD populations.
Clin Psychol Rev. 1999 Jan;19(1):79-96.
The use of writing, alone or in conjunction with traditional psychotherapy, has increased substantially in recent years. The most widespread use of writing has been for single-shot ad hoc purposes or to log behavior. The purpose of this review is to summarize a decade of research demonstrating the efficacy of writing about past traumatic experiences on mental and physical health outcomes. It is widely acknowledged in our culture that putting upsetting experiences into words can be healthy. Research from several domains indicates that talking with friends, confiding to a therapist, praying, and even writing about one’s thoughts and feelings can be physically and mentally beneficial. This review highlights advances in written disclosure that determine some therapeutic outcomes. In addition, we attempt to explore the mechanisms that predict improved psychological and physical health. Finally, limitations of previous studies are highlighted, and suggestions for future research and application are made.
J Lang Soc Psychol. 2009 Sep;28(3):281-296. Epub 2009 Jan 5.
This study investigated whether relative changes in cognitive, emotion, temporal, and self-reference word frequencies in repeated narratives predicted improvements in mindfulness skills (i.e., nonjudgmental acceptance of present-moment experiences, observing and describing present stimuli, and acting with awareness) subsequent to narrative self-disclosure. Participants wrote repeated narratives of traumatic or daily events over 3 days. Mindfulness was assessed at baseline and 4 to 8 weeks posttask. Results indicated that relative increases in cognitive processing words (among traumatic events participants and women in both conditions) and present tense words (among all participants) significantly predicted increases in nonjudgmental acceptance, describing, or overall mindfulness. Increases in present tense words appeared to partially mediate the higher mindfulness outcomes of participants writing about daily events when compared with those writing about trauma. The findings suggest that linguistic changes in self-disclosure narratives are associated with improvements in specific mindfulness skills.
J Clin Psychol. 2009 Sep;65(9):971-88. doi: 10.1002/jclp.20600.
This randomized study examined whether narrative emotional disclosure improves mindfulness, experiential avoidance, and mental health, and how baseline levels of and changes in mindfulness and experiential avoidance relate to mental health. Participants (N=233) wrote repeated traumatic (experimental condition) or unemotional daily events narratives (control condition). Regression analyses showed neither condition nor gender effects on mental health or experiential avoidance at a 1-month follow-up, although the control condition significantly increased in one component of mindfulness. Decreased experiential avoidance (across conditions) and increased mindfulness (in the experimental condition) significantly predicted improved mental health. Narrative disclosure thus did not improve outcomes measured here. However, increasing mindfulness when writing narratives with traumatic content, and decreasing experiential avoidance regardless of writing content, was associated with improved mental health.