Article #740

By Chris Woolston, M.S.

Researchers have found that people who write about their deepest thoughts and feelings surrounding upsetting events have stronger immunity and visit their doctors half as often as those who write only about minor events. Exciting research in the Journal of the American Medical Association shows that writing about a stressful experience reduces physical symptoms in patients with chronic illnesses. One study of 112 patients with arthritis or asthma showed amazing results.

Even psychologists get the blues. As James Pennebaker’s marriage started to flounder, the noted therapist sunk into a massive depression. After a month of misery, he turned to a trusted source of comfort: his typewriter. Each afternoon, he pounded out his thoughts about his failing marriage and other crucial issues, from sex to death. He didn’t realize it at the time, but the words on those pages would turn his life around.

As Pennebaker notes in his book Opening Up (Guilford Press, 1997), his typewriter quickly led him out of depression. “For the first time in years — perhaps ever — I had a sense of meaning and direction,” he writes.Pennebaker’s experience inspired him to devote much of his career to studying the therapeutic value of writing. Over the years, he and many other researchers have found that writing consistently makes people feel happier and healthier. In fact, recent research suggests it may even help ease the symptoms of serious non-psychiatric diseases.

What type of writing works best?

It’s not fiction, poetry, or the daily musings that most people put in their diaries. In every study, subjects got the most benefit by writing about stressful or traumatic events in their lives. Such writing is emotionally taxing, and people often feel heavy-hearted as they put their darkest memories into words. But the short-term pain leads to some impressive rewards. What are the benefits of writing? Whether the writers are medical school students or prisoners, grade-schoolers or nursing home residents, the results are the same:

Writing works

Blood tests show that subjects have more robust immune systems several weeks after completing such writing exercises, according to Pennebaker. They also tend to take fewer trips to the doctor, report lower levels of pain, use fewer medications, function better in day-to-day tasks, and score higher on tests of psychological well-being.

As Pennebaker and many others have discovered, writing is an especially effective remedy for depression. Countless patients have felt their spirits lift as they captured their anxieties and concerns on paper. And in a recent study at Carnegie Mellon University, students who wrote about their anxieties concerning an upcoming exam were much less likely than other students to show signs of depression. The value of writing goes beyond mood disorders.

A groundbreaking study published in the April 14, 1999 issue of the Journal of the American Medical Association shows that writing about past traumas can even ease the symptoms of asthma and rheumatoid arthritis. Encouraged by these results, researchers at the University of Alabama at Birmingham and the University of Texas recruited 45 elderly patients from primary care clinics for a new study.

Most of these patients had everyday complaints of joint pain, back pain, and stomach problems. Three months later, groups studied enjoyed minor improvement in their symptoms. They also made fewer trips to the doctor and spent less on health care in the following three months. The savings were twice as large for the group that explored stressful events. The researchers concluded that simple writing exercises could be a practical, effective therapy for primary care patients everywhere.

How does writing improve health?

Nobody knows, but the answer probably lies somewhere in the strong connections between stress and disease, says Pennebaker, now a professor of psychology at the University of Texas. Not only can emotional stress lead to depression, it can weaken the immune system, promote heart disease, and worsen the course of arthritis, asthma, cancer, and many other diseases, according to the latest research in neuroscience. And, as Pennebaker explains in his book Opening Up, festering memories can be a major source of stress.

Putting such memories on paper can help defuse the danger, he says. Writing forces a person to confront the past one word at a time, and traumas don’t seem so overwhelming when they’re broken into such small increments. It also gives a person the perfect opportunity to explore and gain new insight into his or her feelings. In fact, studies show that people who use words such as “understand” and “realize” in their writings enjoy the greatest improvements in physical and psychological health.

Pennebaker elaborated on these themes in a report in the Journal of Clinical Psychology. In theory, he writes, “the act of converting emotions and image into words changes the way a person organizes and thinks about the trauma.” And once a person captures a negative event in narrative form, “the event can now be summarized, stored, and forgotten more efficiently.”Because writing is so effective at alleviating emotional pain, Pennebaker believes the process can help treat a wide range of stress-related conditions in addition to asthma and arthritis. In a series of recent studies, Pennebaker and his colleagues have found that writing shows promise as a treatment for smoking cessation, depression, and in improving the health of HIV-positive patients.

Putting pen to paper

Pennebaker suggests writing about life’s current stresses — not necessarily events from the past — whenever your spirits sag. You can write anywhere, but if possible, choose a quiet room where you know you won’t be interrupted. Pay no attention to sentence structure or grammar: Just write constantly for 20 minutes or so. Try to objectively describe the stressful situation and explore your feelings. When you’re done, keep the words to yourself. Writing for an audience may prevent you from truly opening up on paper.

Remember, the actual writing process may be uncomfortable, even exhausting or painful. If you feel yourself losing control of your emotions, take a break and try again later. As the great Czech writer and former president Vaclav Havel once wrote, “I do so often write in a state of agitation, depression, unhappiness, and despair, because I find writing so difficult, and because I am so seldom satisfied with what I write. But when — in my happy moments — my work goes well and proceeds as I had imagined or even better, I rejoice and am as happy as a child…. My sense is that, however absurd, tragic, depressing, or cruel [the story] might be, and despite its upsetting qualities — indeed through them — I would certainly feel it delightful, liberating, and elevating, perhaps to the point of tears. I would be delighted to hear things called by their proper names once more, delighted that being was revealed in all its fullness, and therefore all was not lost.

“Such an experience can’t possibly depress me — in fact, it greatly strengthens my conviction that somehow everything makes sense: our life, our toiling and moiling, our god-forsaken world; in short, that there is some genuine hope left.” As Havel suggests, if you keep up with your writing project, you’ll end up with more than a few pages of words. You’ll have new insights and a new sense of control. And if Pennebaker and other researchers are correct, you just might write your way to better health.Developing a deeper understanding of the event and the emotions it generates helps the brain digest the information. When you analyze a traumatic event, your brain turns it into a story that’s stored more easily. Storytelling can simplify a complex experience. While many people who journal on a regular basis do so because it makes them feel better, until recently there hasn’t been any scientific evidence to prove it. Journal writing has the lowest risk factor imaginable, mentally as well as financially, providing you with the gentlest and safest of therapies. No expertise required, no minimum time required, and you don’t lose the benefits if you miss a time period. There are even instances where the process of journal writing has sustained the writer beyond her anticipated life span, where she lived on precisely in order to finish saying what she had to say.

Unlike more physical stress management techniques such as yoga or exercise, journaling is a viable option for the disabled. And, although some prefer to use a computer, journaling requires only a pen and paper, so it’s less expensive than techniques that require the aid of a class, book, teacher or therapist.

About the Author

Chris Woolston, M.S., is a health and medical writer with a master’s degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

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