This is part 5 (of 5) of a series on journaling to improve health, or what James W. Pennebaker, the seminal scholar on the topic, calls “expressive writing.”   I’ve been doing research into expressive writing, which has been demonstrated to improve mental and physical health, in order to roll my learnings into an interactive experience currently in development.

The expressive writing paradigm, led by James W. Pennebaker’s seminal research, has made the overarching assumption that expressive writers must relive and relieve trauma in order to access health benefits from writing. Laura A. King (2001) contends that writing about past trauma by itself might not be the only manner to approach the expressive writing paradigm:

It is notable that all of these [expressive writing] studies have started with a particular bias—that benefiting from writing must involve encountering and coping with a traumatic event from the past.  This assumption, along with the joint notions of catharsis and insight, that some past trauma is driving current health echoes a Freudian notion of past experiences driving current behavior.  Thus far, explanations of the healing power of writing have been predicated on the notion that individuals must revisit, reexperience, or reevaluate past traumas (799).

In 2001, King found that writing about life goals—i.e. one’s best possible future self—had very similar positive health benefits to writing about trauma.  Participants who wrote about trauma and those who wrote about their best possible selves exhibited enhanced immunity when compared to control groups.

Later, in 2004, Burton & King studied the effects of writing about intensely positive experiences. Instructions for Burton & King’s 2004 experimental group were starkly different to those given in Pennebaker’s initial study on expressive writing (Pennebaker, 1989 [see Pennebaker’s instructions here]). Over the course of three days, participants in Burton & King’s experimental condition were asked to write for 20 minutes after reading the following:

Think of the most wonderful experience or experiences in your life, happiest moments, ecstatic moments, moments of rapture, perhaps from being in love, or from listening to music, or suddenly “being hit” by a book or painting or from some great creative moment. Choose one such experience or moment. Try to imagine yourself at that moment, including all the feelings and emotions associated with the experience. Now write about the experience in as much detail as possible trying to include the feelings, thoughts, and emotions that were present at the time. Please try your best to re-experience the emotions involved.

Research demonstrated that writing about intensely positive experiences, similar to writing about trauma, decreased participants’ doctor visits in the months to come.  These findings call into question the focus on trauma in previous research on expressive writing. Burton and King suggest that writing on negative experiences and writing on positive experiences affect health through different mechanisms. They propose that future research explore writing as a process of self-construction, or the creation of “life story,” by which a “greater understanding of [the writer's] own needs, priorities, emotions, etc.” is reached (Burton & King, 2004, p 160).

References:

Burton, C. M., King, Laura A. (2004) The Health Benefits of Writing About Intensely Positive Experiences. Journal of Research in Personality (Vol. 38, pp 150-163).

King, Laura A. (2001) The Health Benefits of Writing About Life Goals.  Personality and Social Psychology Bulletin  (Vol. 27, No. 7, pp. 798-807).

This is part 4 (of 5) of a series on journaling to improve health, or what James W. Pennebaker, the seminal scholar on the topic, calls “expressive writing.”   I’ve been doing research into expressive writing, which has been demonstrated to improve mental and physical health, in order to roll my learnings into an interactive experience currently in development.

In a 2004 commentary designed to defend the expressive writing paradigm from a press for the “whys” behind it (Sloan & Marx, 2004), James W. Pennebaker admits that the dynamic of the curative mechanism remains unknown.  However, he sums up the finer processes that participants in expressive writing studies undoubtedly experience, which are paraphrased here:

1) Participants organize previously disorganized, emotional memories of events into language, consciously giving the event a newly coherent structure or narrative.  (This mechanism has defied researchers’ understanding—i.e. although it’s tempting to say that story-making or narrative allows participants to better integrate and deal with trauma, they don’t know how or if this process might contribute to health benefits.)

2) Confronting an emotional event, or re-exposing participants to a trauma habituates the participant to the event and reduces the impact of emotional responses to it.

3) After writing about a trauma, people think less about it and free up working memory with which to focus on other tasks.

4) Past trauma effects present social interaction; over time, participants gradually change how they interact with others, are more likely to talk about the trauma, laugh about it, and subtly alter their social circles (Pennebaker, 2004).

The first of these subtle processes is intriguing for many.  Although narrative by itself cannot yet be associated with health benefits, there does appear to be something salutory about the process of changing unstructured thought or feeling into the structure of language.  In most of these studies such a dynamic is present: there is a conscious movement by the individual to give linguistic structure to previously unstructured knowledge.

References

Pennebaker, J.W. (2004). Theories, Therapies, and Taxpayers: On the Complexities of the Expressive Writing Paradigm.  Clinical Psychology: Science and Practice (Vol. 11, No. 2, pp. 138-142).

Sloan, Denise M.; Marx, Brian P. (2004) Taking Pen to Hand: Evaluating Theories Underlying the Written Disclosure Paradigm.  Clinical Psychology: Science and Practice (Vol. 11, No. 2, pp. 121-137).

This is part 3  (of 5) of a series on journaling to improve health, or what James W. Pennebaker, the seminal scholar on the topic, calls “expressive writing.”   I’ve been doing research into expressive writing, which has been demonstrated to improve mental and physical health, in order to roll my learnings into an interactive experience currently in development.

In 2002, when Graybeal, Sexton and Pennebaker tested the hypothesis that narrative was the curative mechanism in writing (Pennebaker & Seagal, 1999), their results went a little wonky.  They predicted that writing a good story (one with a beginnng, middle and an ending) would bring their authors the most positive health benefits.  However, they weren’t able to match good stories in expressive writing samples with health benefits in their writers.  They concluded that “the psychological correlates of story-making are unknown” (Graybeal, Sexton & Pennebaker, 2002, p. 580).

Results were inconclusive largely because barely anyone participating in the study went to a doctor afterward.  Researchers simply couldn’t say if the sessions had any effect on participants’ health.  Additionally, in measuring the number of participants who did visit their doctors after the study, a slightly higher number of these folks had written essays judged as good stories.  Further, they found that word usage previously thought to be associated with storyness—e.g. causal words like “because” and “reason,” or insight words like “understand” and “realize”—were not associated with the essays judged as good stories.

If the only clear thought in your mind now is, “Huh?” you’re on track with me.

The study did have some curious aspects to its method, though, such as defining a good story as an essay with a beginning, middle and end.  Certainly, the components of a narrative that brings transformational catharsis and resolution must have more going on than this.  Also, doctor visits were only measured for a month after the sessions, which was a much shorter amount of time than other studies’ measurement periods.  Finally, the study asked participants to write about emotional and unemotional topics “in counterbalanced order, separated by five weeks.”  The counterbalancing would seem to neutralize the effects of emotional vs. unemotional writing.  Since it’s emotional writing that has demonstrated health benefits, wouldn’t one wish to compare samples of emotional writing that had good story-making qualities with emotional writings that had poor story-making qualities?

Basically, they didn’t disprove the hypothesis that the creation of narrative contributes to expressive writing’s health benefits.  They simply weren’t able to confirm it.

References:

Graybeal, A; Sexton, J. D.; and Pennebaker, J. W. (2002).  The Role of Story-Making in Disclosure Writing: The Psychometrics of Narrative.  Psychology and Health (Vol. 17, No. 5, pp. 571-581).

Pennebaker, J.W.; Seagal, Janel D. (1999). Forming a Story: The Health Benefits of Narrative.  Journal of Clinical Psychology (Vol. 55, No. 10, pp.1243-1254).

This is part 2 (of 5) of a series on journaling to improve health, or what James W. Pennebaker, the seminal scholar on the topic, calls “expressive writing.”   I’ve been doing research into expressive writing, which has been demonstrated to improve mental and physical health, in order to roll my learnings into an interactive experience currently in development.

In studies, expressive writing has been consistently shown to improve mental and physical health; however, there is no agreement about how it works.

Some propose that writing enables people to disclose previously repressed thoughts and feelings, the inhibition of which takes physiological effort.  This is called Inhibition Theory, and it suggests that the physiological work of repressing emotion might stress one’s system over time.  Repression leads to decreased immunity and poor health.  Others endorse Cognitive or Behavioral Change Theory, which advocates the notion that people benefit from facing a troubling topic, changing the manner in which they think about it, then changing the manner in which they behave in response to it (Graybeal, Sexton, & Pennebaker, 2002).

As someone with a keen interest in narrative and a background in literature and writing studies, I would suppose that—in addition to Inhibition and Cognitive Change theories—some form of Narrative theory might also be set into the mix.  Human beings are storytellers.  Without stories, we lack meaning–and without meaning, our lives feel nasty, brutish and short.  With a good story, nearly any harsh reality can be transcended or integrated into a meaning that enriches us.

Pennebaker, too, supposed that narrative must be integral to expressive writing’s salutory effects.  In the nineties, he developed a piece of text analysis software called Linguistic Inquiry and Word Count.  LIWC measured the degree to which people used specific categories of words.  Using this software across a range of studies, researchers found that people who benefited from expressive writing went from using fewer causal words, like “because” or “reason,” and fewer insight words, like “understand” or “realize,” to using a high rate of causal and insight words by the end of the study.

Pennebaker & Seagal write, “In reading the essays of people who showed this pattern of language use, it became apparent that they were constructing a story over time.  Building a narrative, then, seemed to be critical in reaching understanding” (Pennebaker & Seagal, 1999).

References

Graybeal, A; Sexton, J. D.; and Pennebaker, J. W. (2002).  The Role of Story-Making in Disclosure Writing: The Psychometrics of Narrative.  Psychology and Health (Vol. 17, No. 5, pp. 571-581).

Pennebaker, J.W.; Seagal, Janel D. (1999). Forming a Story: The Health Benefits of Narrative.  Journal of Clinical Psychology (Vol. 55, No. 10, pp.1243-1254).

We’re working on a project that will involve the audience’s use of an online journal.  The journal is being integrated into an interactive experience that’s designed to help its audience work through inner conflicts and break away from negative patterns.  I can’t say too much about the details (the project is still in the works), but the upshot is that I’ve been doing some research on the benefits of journaling, or what James W. Pennebaker calls ‘expressive writing.’  Pennebaker is the trailblazing scholar behind the discovery that writing expressively improves mental and physical health.

In 1989, Pennebaker performed a study involving undergraduate students who were asked to write for 20 minutes a day for four days in a row.  The control group was asked to write about trivial topics and to refrain from offering any emotional description.  The experimental group was asked to write about the most traumatic event in their lives and to do so with total emotional disclosure.  Here is a copy of the experimental group’s assignment:

For the next four days, I would like for you to write about your very deepest thoughts and feelings about the most traumatic experience of your entire life.  In your writing, I’d like you to really let go and explore your very deepest emotions and thoughts.  You might tie your topic to your relationships with others, including parents, lovers, friends, or relatives, to your past, your present, or your future, or to who you have been, who you would like to be, or who you are now.  You may write about the same general issues or experiences on all days of writing or on different traumas each day.  All of your writing will be completely confidential.

After the study, the students who wrote about “the most traumatic experience” of their lives visited their doctors at a greatly reduced rate compared to the control group (Pennebaker, 1989).

During the last twenty years, researchers have been exploring and expanding this research.  Newer studies have demonstrated that writing expressively about emotionally traumatic or stressful events strengthens immunity, decreases intrusive thoughts & depression, improves grades, and gains faster job placement for the unemployed (Graybeal, Sexton, & Pennebaker, 2002; Lepore, 1997; Spera, Morin, Buhrfeind, & Pennebaker, 1994; and Smyth, 1998).

It’s pretty amazing that writing for just 20 minutes a day for 4 days in a row has this kind of an impact.  Consistently, when measured after weeks and months, expressive writers markedly outpaced control groups in demonstrating better health and positive life changes. Wow.

References:

Graybeal, A; Sexton, J. D.; and Pennebaker, J. W. (2002).  The Role of Story-Making in Disclosure Writing: The Psychometrics of Narrative.  Psychology and Health (Vol. 17, No. 5, pp. 571-581).

Lepore, Stephen J. (1997).  Expressive Writing Moderates the Relation Between Intrusive Thoughts and Depressive Symptoms.  Journal of Personality and Social Psychology (Vol. 73, No. 5. 1030-1037).

Pennebaker, J.W. (1989).  Confession, inhibition, and disease.  In L. Berkowitz (Ed.) Advances in experimental social psychology (Vol. 22, pp 211-244).

Smyth, J.M. (1998). Written Emotional Expression: Effect Sizes, Outcome Types, and Moderating Variables.  Journal of Consulting and Clinical Psychology (Vol. 66, No. 1, 174-184).

Spera, S.P.; Morin, D.; Buhrfeind, E. D.; and Pennebaker, J.W. (1994). Expressive Writing and Coping with Job Loss.  Academy of Management Journal (Vol. 37, No. 3, 722-733).