Those of you who have been reading my blog for a while are well aware of the value I place on writing. I find that any time I’m mulling something over, writing down my thoughts on it really helps give me more clarity. In general, I feel as though I’ve framed writing as a more practical tool – it is a helpful way to organize thoughts on a subject, and writing helps solidify any ideas that one may have.
But it turns out writing does a lot more than that. I recently came across a fascinating paper by James W. Pennebaker and Janel D. Seagal called “Forming a Story: The Health Benefits of Narrative.” The paper is fairly old (1999), and surely more research has been done on the subject since. That being said, I will confine my discussion primarily to this paper for now; in and of itself, it says quite a bit. If people seem interested, I will delve deeper in future posts.
The main thesis of this paper is that writing about your negative experiences has significant health benefits, and these benefits are due at least in part to the process of forming a narrative while writing about the experience over time. As stated in the abstract:
“Writing about important personal experiences in an emotional way for as little as 15 minutes over the course of three days brings about improvements in mental and physical health. This finding has been replicated across age, gender, culture, social class, and personality type. Using a text-analysis computer program, it was discovered that those who benefit maximally from writing tend to use a high number of positive-emotion words, a moderate amount of negative-emotion words, and increase their use of cognitive words over the days of writing. These findings suggest that the formation of a narrative is critical and is an indicator of good mental and physical health. Ongoing studies suggest that writing serves the function of organizing complex emotional experiences."
In this post, I would like to delve further into these results, and specifically discuss the simple ways that you can use this knowledge to your advantage.
Writing: It’s Good For You!
This paper describes numerous studies, but in general, we are more interested in the conclusions than the methodology. That being said, it is beneficial to have an idea of how the basic studies were conducted.
Put simply, the early experiments involved having students (and various other demographics) divided into groups, with the experimental group being tasked to “write about their deepest thoughts and feelings about traumatic experiences,” while the control group wrote about more inane subjects like the decor of the room. Following this assignment, the students (or whichever subjects were involved in a given study) were followed for the rest of the year and had their health monitored. How was their health monitored?
“During the school year, we followed the students’ illness visits to the university health center in the months before and after the experiment. We discovered that those who had written about their thoughts and feelings drastically reduced their doctor-visit rates after the study compared to our control participants who had written about trivial topics. Confronting traumatic experiences had a salutary effect on physical health."
While this is certainly a very limited measure of health, other studies have corroborated these findings using other metrics.
“Four different laboratories report that writing produces positive effects on blood markers of immune function. Other studies indicate that writing is associated with lower pain and medication use and, in a sample of students taking professional-level exams such as the Graduate Record Exam, lower levels of depression. Additional experiments have demonstrated that writing is linked to higher grades in college (Pennebaker & Francis, 1996; Cameron & Nicholls, 1998), and faster times to getting new jobs among senior-level engineers who have been laid off from their jobs (Spera et al., 1994). Several studies have also found that writing or talking about emotional topics influences immune function in beneficial ways, including t-helper cell growth (Pennebaker, Kiecolt-Glaser, & Glaser, 1988), antibody response to the Epstein-Barr virus (Esterling, Antoni, Fletcher, Margulies, & Schneiderman, 1994), and antibody response to hepatitis B vaccinations (Petrie et al., 1995)."
And while better health is certainly a great benefit, it seems that the benefits don’t stop there. According to the authors, “The writing exercise improved their physical health, resulted in better grades, and often changed their lives.” And apparently, 98% of the participants said that they would participate in the study again if given the choice. In other words, most people found that they achieved some kind of benefit from participating in this study and writing about emotional experiences.
Just a quick warning before moving on. While writing about traumatic experiences has been found to have beneficial effects in many settings with many different kinds of people, it may not be effective in cases of extreme depression or PTSD. This technique of writing is aimed more at otherwise healthy people with some serious negative experiences rather than people with major depression or the like. In these cases, don’t try the technique without medical supervision; it may make things worse, unfortunately.
Why Would Writing Make Me Healthier?
After hearing about these results, the obvious question becomes: why? What is the connection between writing about traumatic experiences and being healthier?
Perhaps by writing, somehow people become more health conscious? This seems unlikely, and there is no real evidence to support this.
Or maybe writing, by allowing people to express themselves, leads to some kind of beneficial catharsis? Maybe…but there isn’t much of any research that shows this to be the case.
The authors have a completely different conclusion. They claim that the expression of trauma by itself is not sufficient to elicit these health benefits. In order to get the benefits, one must somehow translate the experience into language. People who tried to express their traumatic experience through interpretive dance did not receive the same benefits. What is it about language that makes a difference here?
“…the act of converting emotions and images into words changes the way the person organizes and thinks about the trauma. Further, part of the distress caused by the trauma lies not just in the events but in the person’s emotional reactions to them. By integrating thoughts and feelings, the person then can construct more easily a coherent narrative of the experience. Once formed, the event can now be summarized, stored, and forgotten more efficiently."
Pretty cool, huh? It seems that creating a narrative or a story to help explain the trauma may help people to understand their experience, and then more easily let go of it. And perhaps, by reducing the stress or burden that the experience entails, your health improves. Of course, it’s never quite so simple; the authors found certain patterns in terms of what kind of writing is beneficial. The process of forging a narrative about an experience isn’t entirely clear cut, and the subtleties of how they are formed have a strong impact on the results. To quote at length:
“Analyzing the use of negative- and positive-emotion words, two important findings were revealed (Pennebaker, Mayne, & Francis, 1997). First, the more that people used positive-emotion words, the more their health improved. Negative-emotion word use also predicted health changes but in an unexpected way. Individuals who used a moderate number of negative emotions in their writing about upsetting topics evidenced the greatest drops in physician visits in the months after writing. That is, those people who used a very high rate of negative-emotion words and those who used very few were the most likely to have continuing health problems after participating in the study. Further, the use of the two types of emotion words was uncorrelated, and the rates of usage did not tend to change appreciably over the days of writing. In other words, those people who tended to use many words in the positive category and a moderate amount in the negative category had the greatest health improvements. In many ways, these findings are consistent with other literatures. Individuals who tend to use very few negative-emotion words are undoubtedly most likely to be characterized as repressive copers—people who Weinberger, Schwartz, and Davidson (1979) have defined as poor at being able to identify and label their emotional states. Those who overuse negative-emotion words may well be the classic high neurotic or, high Negative-Affect (Watson & Clark, 1984) individuals. These individuals are people who ponder their negative emotions in exhaustive detail and who may simply be in a recursive loop of complaining without attaining closure. Indeed, this may be exacerbated by the inability of these individuals to develop a story or narrative. A high rate of positive-emotion word use coupled with some negative-emotion words suggests there is an acknowledgment of problems with a concomitant sense of optimism." [emphasis mine]
In case you didn’t catch that, the types of words you use while constructing the narrative are important. One of the things that this study unfortunately did not discuss is that these patterns are correlations, and that based on the evidence provided, it may only be certain types of people who can actually pull off getting health benefits from writing about traumas. That being said, we don’t know for sure. If you are writing about a traumatic experience, you may be more or less inclined to use negative words, and based on this particular research, we can’t know for sure whether your conscious efforts to write using a specific mix of positive and negative words would have an effect.
Perhaps more interesting is the research on how the use of words change over the course of the experiment:
“Specifically, people whose health improved, who got higher grades, and who found jobs after writing went from using relatively few causal and insight words to using a high rate of them by the last day of writing. 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. Interestingly, those people who started the study with a coherent story that explained some past experience did not benefit from writing (see Mahoney, 1995; Meichenbaum & Fong, 1993; Gergen & Gergen, 1988)." [emphasis mine]
What are “causal” and “insight” words? Causal words, including ones like “because” and “reason”, imply that the writer is putting together some kind of explanation for their traumatic experience. And insight words, such as “understand” or “realize”, show that the writer is thinking about what happened and perhaps coming to terms with it (at least cognitively). The increasing use of these words over the days of the experiment suggest that those who benefited were the ones who constructed a coherent narrative that could help explain their traumatic experience.
Why Do People Form Stories/Narratives About Their Experiences?
To put it most simply, by constructing a narrative, your recollection of the traumatic event becomes biased. While biases are generally a bad thing, in this case, they have therapeutic value. You can take a complex experience and make it more simple and understandable (even though your recollection of the event becomes distorted). By using language to simplify your experience in this way, you can more easily forget or move beyond the experience.
The authors summarize this idea as follows:
“The guiding assumption of the present work is that the act of constructing stories is a natural human process that helps individuals to understand their experiences and themselves. This process allows one to organize and remember events in a coherent fashion while integrating thoughts and feelings. In essence, this gives individuals a sense of predictability and control over their lives. Once an experience has structure and meaning, it would follow that the emotional effects of that experience are more manageable. Constructing stories facilitates a sense of resolution, which results in less rumination and eventually allows disturbing experiences to subside gradually from conscious thought. Painful events that are not structured into a narrative format may contribute to the continued experience of negative thoughts and feelings."
Sign Me Up – How Do I Get These Benefits?
We’ve learned that writing about traumatic experiences can help you form a narrative of those experiences which allows you to move past it – and ultimately, this process leads to improvements in your physical as well as mental health. The question you are surely thinking about now is: how do I take advantage of this?
There are a number of considerations that the paper above addresses, plus I’d like to throw in some of my own commentary and recommendations. But the first issue I’d like to tackle here is this: what level of trauma or emotional experience warrants this kind of writing? I don’t have a hard and fast solution to this question. However, there is research (not discussed in the paper) that demonstrates comparable health benefits when writing about positive experiences. I will use a completely unscientific methodology here, but this suggests to me that you at least have a strong potential to benefit from writing about any situation that you perceive of as negative.
Based on my own anecdotal evidence as well as this wholly unscientific reasoning, I do believe that you can benefit, at least mentally, by writing about any experience or situation that has bothered you in a noticeable way. You need not worry that your experience “isn’t traumatic enough”. If it is causing you some kind of distress, getting your thoughts on paper and constructing a narrative is likely beneficial. But remember: if you have serious depression or PTSD, proceed with extreme caution unless you are under medical supervision.
One final warning: writing about a traumatic or extremely negative experience is likely to have a (predictably) negative impact on your mood in the hours following your writing session. But two weeks after writing, however, those who write about traumatic experiences tend to be happier than those who were in the control groups.
Here are some more things to consider regarding writing about your traumas:
- Writing and talking appear to have similar effects. In both cases, you convert your experience into language and have the potential to form a narrative around it. Feel free to talk it out; personally, I find writing to be more contemplative and it creates a physical product that you can go back, reference, and add to.
- The audience for your writing is irrelevant. Whether you give your writing to someone else or immediately throw it away, there is a benefit. Remember, the key is forming a narrative. This is an internal mental process, and doesn’t necessitate other peoples’ involvement. That being said, if you would prefer to have someone else read it, go ahead.
- Interestingly, writing about someone else’s trauma (as though you lived through it), or even an imaginary trauma, may elicit similar health benefits to writing about your own. This is strange, but it does imply that anyone can benefit from this, whether you have a negative experience to write about or not. The key here is to imagine as though it were your own trauma; writing from a detached perspective will not work.
- In the studies mentioned in this paper, the subjects would typically write for 15-30 minutes per day for several days in a row. I think that spacing out the writing over multiple days allows you to mull over the ideas and form a more coherent narrative than if you did all the writing in one session. It is possible that lengthier periods of writing may be better, but more research needs to be done to see if this is the case. Nevertheless, 15 minutes per day should be very doable, and the research is there to show that this works.
- This may not be easy to implement in practice, but you can keep in mind your use of positive and negative emotion words in your writing. A healthy dollop of positive emotion words, and a “moderate” amount of negative ones seems to be the ticket.
- While everyone can benefit from writing about traumatic experiences, preliminary evidence suggests that men may benefit more than women. More research needs to be done to confirm this, but I mention it here because I suspect that men may be more hesitant to try out this technique. Men – go ahead and try it.
All in all, the research seems to lend strong support to the practice of keeping a daily journal or diary. Having a space to vent and to form a narrative about your experiences can help you get over the things that bother you…and help keep the doctor away, so to speak.
I’ve never kept a journal before. Do you have any ideas or advice about how to get the most from this practice?