Expressive Writing

I'm at a Medical Humanities Conference this weekend, so I felt it was appropriate to talk a little bit about what I've learned. It's' been a lot of things like Yoga and self-reflection, and mainly focused on student wellness, but we've also talked about expressive and narrative writing, and how to go about this. My favorite session was by Nancy Morgan, from the Georgetown Lombardi Cancer Center, who talked about the effects of expressive writing in cancer patients. It made me think about whether the same effects would be seen in pediatric patients, and I think if it hasn't been studied yet, that might be a project I work on.

So, for this post, I'm going to delve a little more into expressive writing: what it is, and what benefits have been reported.

In a nutshell, expressive writing is the writing of emotions. It is intensely deep and personal, and focuses much more on feelings rather than facts. Basically, it's what people think of when they consider a diary or a journal of some type.

Expressive writing has been studied extensively in the past 20 years or so. The pioneer of this research is considered to be James Pennebaker, who has focused his research on traumatic experiences and expressive writing.

Since it is an emotion-based activity, the short-term effects of the writing often include heightened distress, increase in negative mood symptoms, and a decrease in positive mood symptoms. However, the long-term effects can include fewer doctor's visits, improved lung and liver function, reduced blood pressure, improved mood, reduced absences, better working memory, etc.

However, it should be noted that the act of writing itself is not what causes the benefit. Expressiveness was determined to be the deciding factor on whether it was beneficial, with individuals with high expression benefiting more than individuals with low expression. This study concluded that having patients not likely to express their emotions naturally take place in this exercise may actually be harmful, but this is something that may be hard to assess in someone who hasn't written in the past.

Of course, most of these studies looked at 1) traumatic events, and 2) controlled environment with 15-20 minute writing exercises for 3-5 sessions. Nancy Morgan, though, decided to push the conclusions a bit--she had cancer patients write for 20 minutes in a clinic setting--with interruptions and everything included. Essentially, she wanted to look more at real-life scenarios. Participants only did one writing exercise, and were evaluated before and after the exercise. Under these circumstances, patients reported an improvement in perceived quality of life, indicating that it'd be a very useful exercise for these patients, and their caregivers.

Anecdotally, she also reports that the same effects can be seen even if the patients themselves are not the ones writing. In patients who are illiterate, whose stories she is copying down, they have the same overall benefits of the expression than those who are able to write.

So, if you're feeling a little stressed, turns out writing it out in a journal may actually be a good thing to do.