Research on the therapeutic use of writing

In the 1980’s a researcher, James Pennebaker, looked at the use of “expressive writing”, and “accidentally discovered the power of writing” (Pennebaker 2004, p. v). He used a way of writing that had been used by creative writers for many years, often called free or flow writing. In Pennebaker’s case he got students to write for fifteen minutes over four days, on the most significant event in their lives. The results were very positive.

Since then considerable research has been done on “expressive writing”, as it is a technique which can be easily tested, and this has now built up a significant body of research in many different areas.

So, for instance, research has been done in the following areas:

• Improved lung functioning in asthma patients and reduced symptoms in rheumatoid arthritis patients (Smyth, Stone, Hurewitz and Kaell, 1999)
• Reduction in resting blood pressure levels (Crow 2000)
• Psychological effects, such as lowering of depressive symptoms, rumination and general anxiety (Lepore 1997)
• A recent meta-analysis showed that “experimental disclosure is effective, with a positive and significant” effect (Frattaroli 2006, p. 823)

The American Psychological Association published a collection of articles on expressive writing, The Writing Cure, edited by Lepore and Smyth (2002), this includes:

• An analysis of preliminary findings linking expressive writing and reductions in blood pressure (Davidson et al, 2002)
• A reduction in physical symptoms and medical visits for cancer survivors (Stanton and Danoff-Burg, 2002)
• “Expressive writing influences attention and habituation to stressful stimuli and to negative emotions and ... it may influence restructuring of cognitions related to stressors and stress responses.” (Lepore et al, 2002, p.114)

Further, the Cochrane Library has some articles on expressive writing, including the effect on psychotherapy patients: “Clients in the written emotional disclosure group showed significantly greater reductions in anxiety and depressive symptoms as well as greater overall progress in psychotherapy in comparison to the writing control group.” (Graf et al, 2008, abstract).

The National Association for Poetry Therapy in the USA, and Lapidus in the UK, have developed creative writing for health and wellbeing in a large number of areas; trained practitioners are increasingly using creative writing with a variety of clients. 

Further, two recent research studies on the use of therapeutic creative writing with cancer patients show promising results. “These palliative care and cancer patients expressed the ways in which therapeutic creative writing can be beneficial for exploration and expression of personal thoughts, feelings and experiences.”  (Bolton 2008, p. 45), and,” a poetry therapy intervention may improve emotional resilience and anxietylevels in cancer patients” (Tegner et al 2009, p121)

As a practitioner of therapeutic writing I can vouch for the potential power it has when used with clients, it doesn't work for everyone, but it has a significant impact with many people, whether they are working individually or in groups.

References

Bolton G (2008) ‘‘Writing is a way of saying things I can’t say’’— therapeutic creative writing: a qualitative study of its value to people with cancer cared for in cancer and palliative healthcare   Medical Humanities,2008;34;40-46

Crow D M (2000) Physiological and Health Effects of Writing about Stress, (quoted in Pennebaker 2004)

Davidson K, Schwartz A R, Sheffield D, McCord R S, Lepore S J, and Gerin W (2002) Expressive Writing and Blood Pressure, in Lepore S J and Smyth J M, (eds) The Writing Cure, American Psychological Association, Washington

Frattaroli J (2006) Experimental Disclosure and Its Moderators: A Meta-Analysis, Psychological Bulletin, Vol. 132, No. 6, 823–865

Graf MC, Gaudiano BA, Geller PA (2008) Written emotional disclosure: a controlled study of the benefits of expressive writing homework in outpatient psychotherapy, Psychotherapy Research, Vol 18, 4, 389 - 399

Lepore S J (1997) Expressive Writing Moderates the Relation between Intrusive Thoughts and Depressive Symptoms, Journal of Personality and Social Psychology 73: 1030 - 1037

Lepore S J, Greenberg M A, Bruno M and Smyth J M, (2002) Expressive Writing and Health: Self-Regulation of Emotion-Related Experience, Physiology, and Behaviour, in Lepore S J and Smyth J M, (eds) The Writing Cure, American Psychological Association, Washington

Lepore S J and Smyth J M, (2002) (eds) The Writing Cure, American Psychological Association, Washington

Pennebaker J (2004), Writing to Heal, New Harbinger Publications, Oakland

Smyth J M, Stone A A , Hurewitz A  and Kaell A, (1999) Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial, Journal of the American Medical Association 281: 1304 - 1309

Stanton A L and Danoff-Burg S, (2002) Emotional Expression, Expressive Writing, and Cancer, in Lepore S J and Smyth J M, (eds) The Writing Cure, American Psychological Association, Washington

Tegner I, Fox J, Philipp R, Thorne P (2009) Evaluating the use of poetry to improve well-being and emotional resilience in cancer patients, Journal of Poetry Therapy, Vol. 22, No. 3, pp. 121-131