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Emotional and physical benefits of expressive writing
Abstract
Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in non-clinical and clinical populations. In the expressive writing paradigm, participants are asked to write about such events for 15-20 minutes on 3-5 occasions. Those who do so generally have significantly better physical and psychological outcomes compared with those who write about neutral topics. Here we present an overview of the expressive writing paradigm, outline populations for which it has been found to be beneficial and discuss possible mechanisms underlying the observed health benefits. In addition, we suggest how expressive writing can be used as a therapeutic tool for survivors of trauma and in psychiatric settings.
... 8 Expressive writing also has the potential benefits of promoting cognitive processing, creating adaptive internal schemas, and reducing physiological stress resulting from inhibition of negative emotions. 9 There has been prior research done in adult populations regarding expressive writing and chronic disease management that have shown positive results in mental health, daily functioning, baseline disease control, and other health measures . [10][11][12][13] Specifically, there have been narrative medicine and expressive writing interventions in patients with breast cancer and coronary artery disease that have shown improvements in physical and psychological health. ...
Background Individuals with cystic fibrosis (CF) often have psychological difficulties on top of their medically complex care, such as anxiety, depression, and medical mistrust. These have been shown to be associated with worse adherence, pulmonary function test results, and other health outcomes. In this pilot trial, we implemented a journaling program based on narrative therapy methodology to improve mental and physical health outcomes for individuals with CF. Methods Eight adolescents aged 12-17 with a confirmed diagnosis of CF followed in a single center cystic fibrosis clinic were emailed weekly journaling prompts that explored topics like: treatment adherence, feeling different with CF, anxiety, depression, and interpersonal relationships. Subjects were emailed surveys about their experience with the writing assignment, and baseline health data was collected from the electronic medical records. Results The average score for the Pediatric Symptom Checklist (PSC-17) decreased by 5.5 points, and the post-study average (mean 23.5, SD 12.2) fell to less than 28, which is the cutoff for screening positive for behavioral or emotional problems. Participants reported the study was enjoyable and had improvement in feelings of anxiety/depression. 100% of participants responded “Strongly Agree” to the statement “I recommend other people with CF to write about the topics from this study”. Conclusions The journaling intervention for individuals with CF was feasible and well received. Initial results show improvement in PSC-17 and other wellbeing measures. Further studies are needed to evaluate the impact of journaling on mental health and disease outcomes.
... It is worth noting that expressive writing can have short term negative effects such as feelings of distress in some individuals. This might make it difficult to engage in the journaling practice, even if the immediate effects dissipate and in the longer term lead to benefit [Baikie and Wilhelm, 2005]. However as noted expressive writing may not be needed on a regular basis, but rather to reflect on specific highly emotional experiences. ...
The great behavioral heterogeneity observed between individuals with the same psychiatric disorder and even within one individual over time complicates both clinical practice and biomedical research. However, modern technologies are an exciting opportunity to improve behavioral characterization. Existing psychiatry methods that are qualitative or unscalable, such as patient surveys or clinical interviews, can now be collected at a greater capacity and analyzed to produce new quantitative measures. Furthermore, recent capabilities for continuous collection of passive sensor streams, such as phone GPS or smartwatch accelerometer, open avenues of novel questioning that were previously entirely unrealistic. Their temporally dense nature enables a cohesive study of real-time neural and behavioral signals. To develop comprehensive neurobiological models of psychiatric disease, it will be critical to first develop strong methods for behavioral quantification. There is huge potential in what can theoretically be captured by current technologies, but this in itself presents a large computational challenge -- one that will necessitate new data processing tools, new machine learning techniques, and ultimately a shift in how interdisciplinary work is conducted. In my thesis, I detail research projects that take different perspectives on digital psychiatry, subsequently tying ideas together with a concluding discussion on the future of the field. I also provide software infrastructure where relevant, with extensive documentation. Major contributions include scientific arguments and proof of concept results for daily free-form audio journals as an underappreciated psychiatry research datatype, as well as novel stability theorems and pilot empirical success for a proposed multi-area recurrent neural network architecture.
... As one of the core elements of CBT (38,40), automatic thoughts training aims to identify and dismantle these thoughts (i.e., replace negative thoughts with rational perspectives), which could reduce mental distress and improve one's mood (38,41). In addition, previous studies have shown that writing about stressful or emotional events improves physical and psychological health in non-clinical and clinical populations (42,43). Therefore, we adopted over 20 guided expressive writing exercises that cover a variety of topics and instruct users throughout each step of the exercise via interactive conversations. ...
Introduction:
The growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. To this end, we introduce Emohaa, a conversational agent that provides cognitive support through CBT-Bot exercises and guided conversations. It also emotionally supports users through ES-Bot, enabling them to vent their emotional problems. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress.
Methods and results:
Following the RCT design, the current study randomly assigned participants into three groups: Emohaa (CBT-Bot), Emohaa (Full), and control. With both Intention-To-Treat (N=247) and PerProtocol (N=134) analyses, the results demonstrated that compared to the control group, participants who used two types of Emohaa experienced considerably more significant improvements in symptoms of mental distress, including depression (F[2,244]=6.26, p=0.002), negative affect (F[2,244]=6.09, p=0.003), and insomnia (F[2,244]=3.69, p=0.026).
Discussion:
Based on the obtained results and participants' satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.
... Evidence demonstrates that patients completing EW as an intervention can have emotional and physical health benefits (Baikie & Wilhelm, 2005), such as reduced pain and a reduced need to use healthcare services (Rosenberg et al., 2002). Ziemer (2014) explored the comparison between self-compassion focused EW (imagining what a friend would say to them about their pain) and self-efficacy focused EW (enhance confidence in managing the pain) in participants sourced from chronic pain forums. ...
... Ekspressiivisen kirjoittamisen vaikutuksista psyykkiseen ja somaattiseen terveyteen on julkaistu jo kolmatta sataa kokeellista tutkimusta. Kirjoittamisen on havaittu esimerkiksi vähentävän terveyspalveluiden käyttöä terveessä väestössä (45), tehostavan immuunipuolustusta (46) ja helpottavan monenlaisista somaattisista ja psykiatrisista ongelmista kärsivien potilaiden vointia (47). ...
Kirjoittamisen vaikutuksia psyykkiseen ja fyysiseen terveyteen on tutkittu kokeellisesti 1980-luvulta lähtien. Jo muutaman kerran kirjoittamisinterventio näyttää vaikuttavan terveyteen myönteisesti, mutta julkaisuharha ja väärät positiiviset havainnot vaikeuttavat tulosten tulkintaa. Vaikka omista elämänkokemuksista kirjoittaminen voi vaikuttaa terveyteen, kirjoittaminen ei ole ensisijaisesti biolääketieteellinen interventio. Kirjoittamista käytetään terveydenhuollossa vakiintuneena menetelmänä, jonka avulla kliinikko voi reflektoida omia arvojaan ja muistuttaa itseään potilaan näkökulmasta.
Evidence presents the importance of a disease-modifying lifestyle as part of a complete treatment package in multiple sclerosis, and this is now backed up with policy and guidance. However, optimised management bringing together individualised treatments, medications and lifestyle modifications requires clinical time and engaged patients. Charlie Peel explores the evidence base, presents some of the challenges, and highlights the available support for this new model of care.
Seventy-two male and 73 female undergraduates were randomly assigned to an experimental group, in which they wrote expressively about a relationship breakup, or to a control group, in which they wrote in a non-emotional manner about impersonal relationship topics. Control participants reported short-term increases in upper respiratory illness (URI) symptoms, tension and fatigue, whereas experimental participants did not. Further, higher levels of intrusive thoughts and avoidance were associated with short-term increases in URI symptoms in the control group, but were unrelated to URI symptoms in the experimental group. Finally, there was a trend (p Keywords: Avoidance; Emotional expression; Expressive writing; Intrusive thoughts; Social adjustment; Upper respiratory illness Document Type: Research Article DOI: http://dx.doi.org/10.1080/08870440290025768 Affiliations: 1: Department of Health and Behavior Studies, Teachers College, Columbia University, Thorndike Hall, Box 114, 525 West 120th Street, New York, NY 10027, USA 2: Clinical Psychology, Alliant International University, 10455 Pomerado Rd., San Diego, CA 92131, USA Publication date: January 1, 2002 $(document).ready(function() { var shortdescription = $(".originaldescription").text().replace(/\\&/g, '&').replace(/\\, '<').replace(/\\>/g, '>').replace(/\\t/g, ' ').replace(/\\n/g, ''); if (shortdescription.length > 350){ shortdescription = "" + shortdescription.substring(0,250) + "... more"; } $(".descriptionitem").prepend(shortdescription); $(".shortdescription a").click(function() { $(".shortdescription").hide(); $(".originaldescription").slideDown(); return false; }); }); Related content In this: publication By this: publisher In this Subject: Psychology By this author: Lepore, Stephen J. ; Greenberg, Melanie A. GA_googleFillSlot("Horizontal_banner_bottom");
Although the expressive writing paradigm has generally produced positive health outcomes, a recurring puzzle concerns how and why it works. No single theory or theoretical perspective has convincingly explained its effectiveness. This may be attributable to the fact that expressive writing affects people on multiple levels-cognitive, emotional, social, and biological-making a single explanatory theory unlikely. In addition to addressing theory-relevant questions, researchers and therapists must now address when and with whom writing is most beneficial and, at the same time, evaluate if this (and other) intervention produces economically valuable outcomes.
An emotive writing intervention (Pennebaker. 1997a. 1997b) was applied to improve our understanding of the previously observed negative relationship between mood awareness and the athletic performance of collegiate tennis players (Scott, Stiles. Raines. & Koth. 2002). A comparison group, interrupted time series design was employed to study a sample of 13 Division II collegiate tennis players who participated during the Spring 2002 season. It was expected that participants who were classified as mood monitors would experience a differential benefit from emotive writing compared to those classified as mood labelers. Mood monitors" athletic performance showed a delayed benefit from the writing intervention while mood labelers' athletic performance showed no appreciable improvement following intervention. Based on these data, sport psychologists should consider closely inspecting the mood awareness tendencies of athletes before attempting an emotive writing intervention.
We have been closet Cartesians in modern medicine, treating the mind as though it were reactive to but otherwise disconnected from disease in the body. Although medical science has productively focused on the pathophysiology of disease, such as tumor biology, coronary artery disease, and immunology, it has done so at the expense of studying the body's psychophysiological reactions to these disease processes. These reactions are mediated by brain and body mechanisms, including the endocrine, neuroimmune, and autonomic nervous systems. While a large portion of the variance in any disease outcome is accounted for by the specific local pathophysiology of that disease, some variability must also be explained by host resistance factors, which include the manner of response to the stress of the illness. For example, in a series of classic experiments in animals, Riley¹,2 showed that crowding accelerated the rate of tumor growth and mortality. In a recent authoritative review of human stress literature, McEwen³ documented the adverse health effects of cumulative stressors and the body's failure to adapt the stress response to them. Activation of the hypothalamic-pituitary-adrenal axis (HPA) is an adaptive response to acute stress, but over time, in response to cumulative stress, the system's signal-to-noise ratio can be degraded, so that it is partially "on" all the time, leading to adverse physiological consequences, including abnormalities of glucose metabolism,⁴ hippocampal damage,⁵ and depression.⁶,7
