Expressive Writing: Write Yourself Healthy

Do you think that keeping a diary can protect you from colds? Or even alleviate chronic illnesses? Psychologists James Pennebaker and Joshua Smyth made these bold claims – and were proven right.

Both researchers knew all too well the pleasant, light feeling of a mental cleansing that comes from keeping a diary. With this idea in mind, they set out on an experiment in the late 1980s. They had two groups of participants write about everyday life and traumatic childhood experiences for four consecutive days. The results were astonishing: participants who wrote about very personal childhood experiences visited a doctor half as often in the following six months as the control group. The birth of expressive writing had been heralded. [1] [1] The History of Expressive Writing: Pennebaker, James W., Smyth, Joshua M. (3rd edition, 2016): Opening Up by Writing It Down  >

Expressive Writing vs. Free Writing

Expressive writing, also known as therapeutic writing, is used to process emotional burdens and to maintain “psychological hygiene.” [2] [2] Keeping the attic clean: Wikipedia: Definition of Psychological Hygiene   It's essentially a dental visit for the brain: not always pleasant, but in the end, you're glad you took care of it. 

Just like with automatic or free writing, the writing process is intended to take place uninhibited and uncensored. [3] [3] How free writing works: Contentman (2017): Automatic Writing Instructions and Experiences  Thoughts flow onto the paper as unfiltered as possible, while grammar, spelling, and beautiful handwriting play no role. If possible, it is written by hand. [4] [4] The pen is mightier than the keyboard: Mueller, Pam A.,  Oppenheimer, Daniel M. (2014): Advantages of Longhand Over Laptop Note Taking  >

The crucial difference between the two writing techniques is that in expressive writing, regardless of the topic, two questions are to be answered as precisely as possible:

1. What happened?
2. How do I feel about it?
   

The Burden of Our Secrets

The idea of expressive writing is based on one of the oldest basic assumptions in psychology, which even led Freud to invite people onto his couch: It feels good to talk about feelings and thoughts. It sounds simple, and it is – but how often do you have to overcome yourself to confide your most personal feelings and thoughts to other people? 

Even if you haven't sworn confidentiality regarding your inner life, there are certainly topics that you hardly or never speak about openly. The fault lies with societal expectations (e.g., men are not emotional) or norms that your parents taught you (e.g., we don't talk about money). Perhaps your thoughts also seem trivial and silly to you, such as a guilty conscience you've carried since childhood because you once stole a sweet from the neighbour's child. So you certainly have secrets in the broader sense. 

What you probably don't consciously realise: It takes effort to keep something to yourself. How demanding it is for our brain to keep a secret is shown by an experiment: participants who were asked to actively withhold information about themselves performed about 17% worse on a subsequent test of spatial reasoning than the control group. Even their physical strength was reduced by 30% by the secrecy. [5] [5] Burdensome secrets: Spektrum (2018): Why we have secrets  >

Conversely, this means you have more cognitive capacity and physical strength available when you deal openly with your secrets. The great advantage of expressive writing: The paper on which you lay out your most intimate thoughts won't judge you for anything or blab. If you want to be completely sure, you can even destroy what you have written. The effect remains!

Everyone is a moon and has a dark side that they show to no one. – Mark Twain

What expressive writing brings you

When Pennebaker and Smyth noticed the decline in doctor visits among the participants in their study, they concluded that writing therapy strengthened the participants' immune systems. Minor ailments such as colds seemed to affect them less. This phenomenal finding triggered euphoria in the research world and led to numerous further studies.

Greatest potential for victims of sexual violence

Existing research showed that childhood trauma leads to chronic illnesses. [6] [6] Modern research also confirms: trauma leads to chronic illnesses: Sonu, S., Post, S., Feinglass, J. (2019): Adverse childhood experiences and the onset of chronic disease in young adulthood  Pennebaker and Smyth suspected that victims of sexual violence speak less about their terrible experiences than other traumatised people due to the stigma. Their assumption was indirectly confirmed by the fact that participants who wrote about sexual trauma in the experiments showed the most significant health improvements. 

Improvement of chronic illnesses

Further studies indicated an improvement in chronic illnesses, regardless of whether the stressors were in childhood or came from the patients' current daily lives. The effect of expressive writing was investigated on a wide range of illnesses such as asthma, diabetes, cancer, HIV/AIDS, high blood pressure, as well as depression and other mental illnesses. 

In all illnesses, expressive writing generally showed positive effects on coping with the illness as well as symptom relief and pain reduction. However, to this day it is unclear whether expressive writing actually has a direct effect on the illness. Researchers suspect that it works indirectly by supporting psychological processes and thereby freeing up mental capacity that promotes the healing process. Like on a construction site, the damage is repaired more effectively the more hands pull together. Even if individual writing sessions won't resolve your trauma, they will give you a little breathing room to have more strength for your recovery.

And even if not all patients benefit from the positive effects, writing therapy shows a major advantage compared to pharmaceutical means: no side effects could be detected.

Faster wound healing

Ouch! Minor accidents with a kitchen knife or while picking up broken glass are not only unpleasant, but always carry the risk of infection. The faster the wound heals, the better! Researchers in a study with older participants (64 to 97 years) prescribed expressive writing to one group to treat a four-millimetre-deep cut, while the other group merely noted their daily activities. Only 42% of the latter group could show a closed wound after eleven days. In contrast, the wound was completely healed in 76% of the “Expressionists.” [7] [7] Faster wound healing in older people: Booth et al. (2013): Expressive writing and wound healing in older adults: a randomized controlled trial. 

Promoting professional success

The positive effects of expressive writing are not limited to health. In one of the studies, participants who were currently looking for a job were invited. In the group that wrote about their deepest thoughts and feelings, 53% found a new job within seven months after the experiment. In the control group, it was only 18%.

How expressive writing works

“Writing your worries off your soul” sounds like a wonderful thing – but can it really be that simple? What exactly does expressive writing do to us? The effect can be broken down into the following seven dimensions: 

1. Acknowledge the problem: Problems can be as present as the proverbial elephant in the room, and yet we sometimes pretend nothing happened. Through the questions What happened? and How do I feel about it? we name the problem.
   
   
2. Find logic and structure: While writing, you will automatically use words that help you put the problem into temporal and logical contexts. (For example, when you use conjunctions like after, before, because, therefore, because of that (you use them).
   
   
3. Recognise connections: Free writing allows you to abstract your feelings, thoughts, or behaviour and compare them with other situations. Perhaps you notice a pattern?
   
   
4. Create distance: Through the objective description of the problem, you are less at the mercy of your feelings and view the problem more objectively.
   
   
5. Use storytelling: Through repeated writing, you can soon put the experience into a shorter, coherent story. This shortened version makes it easier for you to open up to others, if you want to or perhaps even have to.
   
   
6. Increase well-being: You notice the positive effects of writing, which have been proven in numerous studies: Your stress level is reduced, your sleep improves, you feel better overall.
   
   
7. Nurture relationships: Through expressive writing, you clear your head to allow yourself to engage more with your circle of friends or family. Perhaps you will even find social support there for your further healing process?

Instructions for your self-experiment

Now we come to the practical application! Below you will find a translation of the original instructions from Pennebaker and Smyth's experiments.

In the coming four days [with 20-minute writing sessions each] I ask you to write about your deepest feelings and thoughts, related to the most distressing experiences of your life. Let go of all inhibitions [and do not pay attention to grammar, spelling, or beautiful handwriting] [..]. Perhaps you will refer to events in your childhood. Write about your relationship with your parents, about people you loved or still love today, or about your career path. How do these experiences relate to the person you want to become, the person you were in the past, or the person you are today?

Many people have no traumatic experiences to report, but each of us has experienced difficult conflicts or stressful situations in our lives. You can write about these [experiences] as well. You can write about the same topic on all four days or about a series of different problems. [..]

Warning: Many report that they feel sad or depressed after writing—just as you might feel down after a sad movie. However, this feeling disappears after a few hours. If you notice that a topic particularly upsets you, you can stop writing at any time or change the topic.

[Additional note: If you are in therapy, discuss this writing exercise with your therapist.]

How often and how long?

Expressive writing can be used as an intervention and also as prevention. Like at the dentist, you can either schedule a check-up every few months or perform a treatment for acute problems. Trust yourself; you know best what you need. 

In the studies, no difference in effect could be detected based on the frequency of writing. However, Pennebaker and Smyth recommend at least three 15-minute sessions within a period that seems suitable to you to observe changes.

It is the spirit that builds the body. – Friedrich Schiller

Further applications of expressive writing

In the early stages of their research, the psychologists focused on trauma and negative experiences in the past. Later, the positive effects of expressive writing could also be proven for other applications. The following occasions offer opportunities for writing:

• Recurring thoughts and rumination
• Sleep problems
• Decisions
• Major life changes such as marriage, moving, changing careers
• Beautiful experiences

Make room in your head

To help you easily remember the key points of this article, I’d like to give you one more image to take with you. Imagine a huge archive. All your past experiences, along with the thoughts and feelings associated with them, are written on index cards and filed in corresponding filing cabinets. Now, imagine you’ve had a distressing experience, such as an argument, an accident, or an injustice. You are preoccupied with it, consciously or unconsciously. A bunch of index cards detailing this conflict are flying around your metaphorical desk, and you find it hard to concentrate on anything else. 

Now it’s time to clear things up! This is exactly what you can use expressive writing for. You sort through the index cards, put them into piles, and maybe you even finally find the right filing cabinet and can file them under B for Bad luck or L for Learning experience. 

Good luck trying it out! Feel free to share your experience in the comments.

Want to write even more? Here you’ll find ideas about all the things you can write in your diary.

____________________

This post was written by Amelie Haupt. Thanks to her studies in business psychology, she is the “Psycho-Aunt” of the 6-Minuten-Verlag. She likes her texts the way she likes her life: with structure. She needs it when she’s out and about as a digital nomad again, too.

Sources:

Note: The original work by psychologists Pennebaker and Smyth served as the basis for this research. See source 1.

[1] The history of expressive writing: Pennebaker, James W., Smyth, Joshua M. (3rd edition, 2016): Opening Up by Writing It Down 

[2] Keeping the attic clean: Wikipedia: Definition of psychohygiene

[3] How free writing works: Contentman (2017): Automatic Writing: Guide and Experiences

[4] The pen is mightier than the keyboard: Mueller, Pam A.,  Oppenheimer, Daniel M. (2014): Advantages of Longhand Over Laptop Note Taking

[5] Burdensome secrets: Spektrum (2018): Why We Have Secrets

[6] Modern research also confirms: trauma leads to chronic illness: Sonu, S., Post, S., Feinglass, J. (2019): Adverse childhood experiences and the onset of chronic disease in young adulthood

[7] Faster wound healing in older adults: Booth et al. (2013): Expressive writing and wound healing in older adults: a randomized controlled trial.