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Research Article
Haiku and Healing: An
Empirical Study of
Poetry Writing as
Therapeutic and
Creative Intervention
Kittredge Stephenson
1,*
and David H. Rosen
1,*
Abstract
Haiku poetry was investigated in the context of the expressive writing paradigm to
evaluate its potential benefits. Participants, 98 introductory psychology students at a
large southwestern university, wrote for 20 min a day on 3 consecutive days and
completed self-report measures of happiness, life satisfaction, spiritual meaning, cre-
ativity, physiological symptomatology, depression, anxiety, and health/illness orienta-
tion at baseline and 3-week follow-up. A series of analysis of covariance linear contrasts
were used to examine differences between groups writing narrative about a neutral
topic, haiku about a neutral topic, haiku about nature, or haiku about a negative life
event. Writing in narrative about a neutral topic led to decreases in anxiety and
depression. Participants writing haiku about nature or a negative life event reported
increased creativity, and writing haiku about nature led to decreased illness orienta-
tion. The present findings suggest that narrative writing leads to decreases in anxiety
and depression, while haiku writing increases creativity and sensitivity to topic. The
value of haiku and the arts are discussed for the writing paradigm and beyond.
Keywords
expressive writing paradigm, creativity, poetry, haiku, arts, positive psychology,
psychological health
Empirical Studies of the Arts
2015, Vol. 33(1) 36–60
!The Author(s) 2015
Reprints and permissions:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/0276237415569981
art.sagepub.com
1
Department of Psychology, Texas A&M University, College Station, TX, USA
*
Kittredge Stephenson is now a postdoctoral fellow at The Menninger Clinic, Baylor College of Medicine.
David H. Rosen is now an affiliate professor in psychiatry at the Department of Psychiatry, Oregon Health
& Science University. This article is based upon the Master’s research of the first author.
Corresponding Author:
Kittredge Stephenson, The Menninger Clinic, 12301 Main Street, Houston, TX 77035, USA.
Email: kstephenson@menninger.edu
We all have creative moments in daily life, the results of which are unlikely to
grace the halls of any museum. Richards has referred to such instances as
“everyday creativity” (Richards, 2007a). A number of researchers have argued
for the mental and physical health benefits that come with such engagement
(Cropley, 1990; Richards, 2007a, 2007b; Runco, Ebersole, & Mraz, 1991;
Runco & Richards, 1998). They point to the way in which engaging in the
arts can help people recover from serious illnesses or trauma; how elderly
people who exhibit traits associated with creativity, such as divergent thinking,
have better health outcomes; and the like. Direct experimental evidence in sup-
port of the benefits of everyday creativity, however, is limited. The kind of work
that might fall under everyday creativity is often done in the context of art
therapies, thus confounding artistic and therapeutic mechanisms of change
(Brooke, 2006; LeLieuvre, 1998; Mizushima, 1971).
One study, however, found that in some groups of musicians, lower stress
levels were correlated with increased creativity (Nicol & Long, 1996). The two
study groups consisted of music hobbyists and music therapists, and the hob-
byists exhibited the correlation while the music therapists did not. The research-
ers suggested that the music therapists did not exhibit the same change because
they would likely have more coping resources and thus would not rely as much
on music to manage stress. Another way of interpreting these findings, however,
would be with respect to their different relationships to playing music. For the
hobbyists, playing music would be more simply associated with leisure, whereas
for the music therapists, playing would also be associated with their profession,
even if they were not practicing it in that moment.
Kaufman and Beghetto (2009) have presented a model that distinguishes four
levels of creativity. The “mini-c” level refers to the “novel and personally mean-
ingful interpretation of experiences, actions, and events” and speaks to the cre-
ativity inherent in the learning process. The “little-c” level captures focused
creative engagement as it is found in daily life, from developing a novel way
of repairing an item or fixing a meal, to writing or painting without reference to
a particular level of proficiency. “Pro-c” acknowledges a level of mastery in a
specific field of endeavor, the level of skill that comes with approximately 10,000
hr of deliberate practice (Ericsson, 2006). Finally, “Big-C” is reserved for emi-
nent creators whose contributions transform a field and potentially extend
beyond it; these individuals are often familiar names.
Returning to the Nicol and Long study (1996), the results could be inter-
preted as certain effects being available at lower levels of creative engagement
(mini-c or little-c), but diminished as individuals engage with increasing inten-
tion toward professional performance. There is a difference, of course, between
training on an instrument with the intention of aiding others therapeutically
versus training for a recital, but both endeavors would call for a level of inten-
tionality and deliberate practice not necessarily involved for the music hobbyists.
Runco cited a series of studies to make a similar point with respect to humor
Stephenson and Rosen 37
(Runco, 2006, p. 149; see also Vilaythong, Arnau, Rosen, & Mascaro, 2003).
Humor in normal samples was strongly correlated with creativity and connected
to positive physical and psychological health outcomes. On the other hand,
comedians (Pro-c or Big-C) did not exhibit longer lives or better outcomes
than others. These findings suggest indirectly that there may be advantages to
engaging in creative pursuits at lower levels of creativity that diminish when they
are pursued with greater intensity.
Since the introduction of positive psychology, creativity has been connected
with studies demonstrating the psychological value of positive emotions and
behaviors (Lopez & Snyder, 2011; Seligman & Csikszentmihalyi, 2000; Silvia
et al., 2014). One area of focus within positive psychology has been happiness
and life satisfaction (Diener, Lucas, & Oishi, 2009). According to this research,
happiness involves three components—positive affect, negative affect, and life
satisfaction—and the frequency with which positive emotions are experienced is
more important than their intensity. In addition, it is important how individuals
compare themselves with others; whether they are always looking at those better
off, for example, or comparing themselves with those less fortunate. Diener (2009)
has noted that people need to be taught how to like what they have, rather than
like what they want, in order to improve their life satisfaction. Happiness has also
received a significant amount of attention (Dalai Lama XIV & Cutler, 1998),
which would suggest that methods for increasing positive affect throughout the
day would be both valued in society and lead to greater happiness.
The Expressive Writing Paradigm
One area of study that speaks to both the little-c arena of creativity and has been
influenced by positive psychology is the expressive writing paradigm. A signifi-
cant literature has documented the therapeutic effects of writing in narrative
form across age, gender, culture, social class, and personality type (Frattaroli,
2006; Pennebaker & Seagal, 1999). The effects have been manifested in reduced
anxiety, depression, and trauma, as well as physiological markers such as fewer
doctor visits and reductions in symptomatology. The mechanisms by which
writing exerts these effects, however, are still being examined (Frattaroli, 2006;
Sloan & Marx, 2004). Researchers now generally agree that such writing con-
stitutes a multiply determined phenomenon that does not lend itself to a single
theoretical explanation (Pennebaker & Chung, 2007). Thus, while certain the-
ories such as emotional processing, cognitive adaptation, exposure theory, and
social integration have each helped explain certain elements of the writing pro-
cess dynamics (Frattaroli, 2006; Sloan & Marx, 2004), investigators have also
encouraged ongoing exploration of alternative models (C. A. King, 2004;
Pennebaker & Chung, 2007).
Following King’s recommendation, one approach has been to apply the basic
writing paradigm to novel topics. Most of this research has been done by Laura
38 Empirical Studies of the Arts 33(1)
King and colleagues. These researchers found, for example, that having partici-
pants write about “intensely positive experiences” (Burton & King, 2004) or
their “best possible sel[ves]” (L. A. King, 2001) not only led them to experience
similarly positive results as in the traditional writing paradigm topics, but also
did not involve the same short-term increase in negative affect that occurs when
writing about trauma. As such, these and other authors have suggested that
positive topics might in fact provide an improvement upon the traditional
topic of a negative life event (Frattaroli, 2006; L. A. King, 2002).
It is worth noting that King (2002) has argued that the benefits of writing
are due to self-regulation of emotions. That is, narrative writing allows for
the opportunity to observe oneself regulating one’s own emotional processes,
thus exerting some control and leading to improvement. Overall, emotional
processing has received some indirect support in that measures of depression,
anxiety, and other aversive affective states have generally decreased in writing
paradigm studies (Frattaroli, 2006). The fact that writing about either negative
or positive affect has led to similar longer term benefits is in keeping with this
theory.
Another method of creative extension that has been used with the writing
paradigm is to apply its basic structure to artistic forms of expression. For
example, Pennebaker discussed an empirical study in his popular book about
writing, Opening Up (1997, p. 99), in which “bodily movement,” that is, expres-
sive dance, was compared with narrative writing. He found that narrative
writing led to significant improvements in physical health and grade point
average, while expressive dance did not yield significant results by itself.
However, a combined group, which did expressive dance and then wrote
about the experience for 10 min afterwards, showed similar improvements to
the writing condition participants. Pennebaker suggested that while artistic
expression is not effective by itself, it can be effective in combination with nar-
rative writing. He further expressed his conviction that art therapies are effective
and that this is likely due to the manner in which the therapist facilitates the
process of translating the artistic experience into a cognitive mode of increased
understanding. These findings are in keeping with the consistently demonstrated
results that significant gains have come in writing about emotional experience in
a manner that leads to cognitive change (Pennebaker & Seagal, 1999). In other
words, the greatest improvement is found when emotional expression and cog-
nitive change are integrated.
Pizarro (2004) found similar results to the expressive dance study when she
compared drawing visual art with narrative writing in a student population.
Narrative writing led to health benefits while drawing did not. However, she
noted a number of ways in which the experimental art participants expressed
more interest in and engagement with the topic than the writing condition
participants. Pizarro suggested for future studies that a combined condition
might be particularly beneficial, which accords with Pennebaker’s results.
Stephenson and Rosen 39
An additional exploration of art in the context of the writing paradigm was
conducted by Henderson, Rosen, and Mascaro (2007), which involved having
participants who reported traumatic stress draw mandalas concerning their
trauma. Drawing mandalas led to decreases in traumatic symptomatology,
though no other significant results were found.
Another approach has been to use poetry in place of narrative writing. Floyd
(2003) compared four groups writing about personal anxieties in the standard
narrative format or in verse, with two matching control conditions. He suggested
that the value of poetry is different than narrative writing. While narrative
writing propels one forward in understanding or integration, the value of
poetry is in making the moment more present and pregnant. Following this
distinction, he hypothesized that writing poetry would lead, among other
things, to an increased experience of flow, which, following Csikszentmihalyi
(2008), involves “a pleasurable state in which a person is so completely involved
in the moment that self-consciousness is minimized and the task at hand is
approached with clarity, a sense of control and intense concentration” (Floyd,
2003, p. 36). He did not find a notable decrease in depression in any group, but
rumination decreased in both the poetic and narrative experimental groups
writing about personal anxieties. The experimental narrative group indicated
more meaning/understanding about personal anxieties, but the experimental
poetry group exhibited more flow.
Thus, studies attempting to apply creativity and the arts alone within the
structured format of the writing paradigm generally have not led to similar
results as writing in narrative form. However, the study authors have noted
how the arts add something unique such that participants often prefer their
experience. It would appear that if these creative extensions are to be used con-
structively in the context of addressing difficult emotions and experiences, using
creativity and the arts requires some structure to help make meaning of them. As
noted above, Pennebaker (1997, p. 101) has mentioned that this structure is
provided in art therapies. In that context, art is used to connect with parts of
the individual’s experience that might not be readily accessible via language, but
is then discussed and integrated so that where art was so language will be. And
indeed, studies have generally supported the efficacy of art therapies (Marrs,
1995).
Returning to the other branch of research that has extended the writing para-
digm, however, it has been found that one need not write about difficult emo-
tions or traumatic experiences in order for writing to be helpful (Burton & King,
2004; L. A. King, 2001). This point raises the question of whether there might be
alternative ways of addressing and working with creativity and the arts that
would lead to different results. It is notable that the studies using art discussed
above all employed topics concerned with distress. Instead of looking solely for
the arts to heal in a manner similar to narrative writing, perhaps there would be
an alternative way of engaging with them.
40 Empirical Studies of the Arts 33(1)
Creativity and the Writing Paradigm
At this point, however, a shift has occurred in how researchers discuss art and
creativity. A number have argued for the centrality of narrative in the writing
paradigm findings (Kaufman & Baer, 2002; Kaufman & Sexton, 2006;
Pennebaker & Seagal, 1999; Smyth, True, & Souto, 2001). They have pointed
to several findings in support of this claim. There is now a large body of litera-
ture demonstrating the link between mental illness, or a vulnerability to it, and
highly creative output (Kaufman, 2001; Ludwig, 1995). It has been noted within
the writing paradigm literature that poets are particularly susceptible to affective
disorders (Kaufman & Baer, 2002). In contrast to the intense engagement with
emotional experience that can accompany poetry, narrative writing may allow
for a more balanced integration of emotional and cognitive experience. Poetry
has been argued to lack this narrative, and as a result, leave poets to drown in a
morass of feelings and other experiences that they are unable to integrate
productively.
It is important to recognize, however, that this research is based upon emi-
nent creators. As such, these individuals might face a host of challenges and have
much more invested in their engagement with the work than would someone
participating in the same field for leisure. Martindale (1975, 1990) has spoken to
the pressures that poets and other eminent creators face in attempting to push
the limits of their art form, which tends to lead them toward regression and
primordial cognition. As the art form becomes increasingly abstract or discon-
nected from daily living, creators are at increasing risk of intrapsychic
disconnection.
Another approach that has been taken in exploring the importance of narra-
tive has involved examining the importance of narrative structure directly by
comparing writing done in a fragmented, list-like manner versus a more fluid
narrative style (Smyth et al., 2001). Salubrious change came only with the nar-
rative style. While this study supported the value of narrative, it did not neces-
sarily provide evidence against poetry, as others have suggested (Kaufman &
Sexton, 2006). Implicit in making this connection is the assumption that poetry
lacks narrative structure, but this has been challenged (Hogan, 2003).
Returning to the studies that have been conducted using the arts in the con-
text of the writing paradigm, they were done not with eminent creators but with
average individuals, for whom the correlation between creativity and mental
illness is likely negligible (Kaufman & Beghetto, 2009). In keeping with these
findings, these studies demonstrate two points. First, engaging in the arts gen-
erally does not lead to deterioration; more often, participants have experienced
some improvements that did not reach statistical significance. Second, there are
some unique characteristics that accompany engaging with the arts in this
manner: increased interest or engagement, increased flow, and increased satis-
faction with the experience. These benefits warrant further attention, as they
Stephenson and Rosen 41
present opportunities both to improve the implementation of the writing para-
digm and to better understand its broader implications.
Haiku Poetry
An art central to Japanese culture, haiku poetry has a long association with Zen
Buddhism (Loori, 2004; Suzuki, 1959). Few are likely to argue that composing
poetry is not creative, but perhaps more notable is how creativity researchers
have pointed out a relationship between Zen Buddhism and creativity (Runco,
2006; Torrance, 1979). As Runco noted (2006, p. 373), the emphasis in Zen on
thinking and being present without classifying shares the same tendency toward
overinclusive thought that has been found to support creativity. Djikic (2014)
has also connected eastern and western perspectives with exposure to art, which
is creative. She first linked eastern and western forms of mindfulness, then con-
nected them with the way in which exposure to art leads to brief moments of
dysregulation in trait-level personality variables that offer invitations toward
increased awareness.
Recently, there has been an increased interest in studying haiku poetry from
empirical and therapeutic standpoints. Blasko and Merski (1998) discussed the
unique opportunity this poetic form provides for interdisciplinary study of cre-
ativity, noting its worldwide popularity and its penchant for ease of use yet
depth of meaning. Therapeutically, haiku poetry has been incorporated into
interventions and exercises within the context of Focusing and Focusing therapy
(Rudnick, 2003; Tsuchie, 2009). Focusing attends to the “felt sense” of bodily
awareness, which is considered a point of access to a more grounded or deeper
sense of knowing (Gendlin, 1978). The simplicity, depth of meaning, and reson-
ant relationship developed between poet and nature all speak to the value of
haiku in this respect.
Haiku is one of the shortest forms of poetry, providing little opportunity for
narrative elaboration. In the context of the above discussion, having participants
compose haiku in the context of the writing paradigm would present the oppor-
tunity to test the theorized centrality of narrative as it is traditionally conceived
in the writing paradigm. The traditional topic for haiku poetry is also nature.
Such a topic provides a contrast to both the traditional topics concerned with
trauma or negative life events on the one hand, and positive but still personal
topics such as one’s life goal or best possible self the other. A large body of
research has suggested that both direct and indirect exposure to nature provide
physical and mental health benefits (Berman, Jonides, & Kaplan, 2008; Walsh,
2011; Wells, 2000), which might also be the case in writing about it.
One study has examined empirically the potential salubrious effects of writing
haiku poetry (Stephenson & Rosen, 2013).
1
Two groups wrote haiku about
either a neutral topic or a nature topic for 20 min a day for 3 days consecutively.
Questionnaires were filled out at baseline, immediately following the writing
42 Empirical Studies of the Arts 33(1)
intervention on the third day, and at a 4-week follow-up. The study authors
found that writing haiku poetry, regardless of topic, led to significant decreases
in anxiety and physiological symptomatology. For those writing haiku poetry
about the traditional topic of nature, there were significant differences in physio-
logical symptomatology and spiritual meaning. In keeping with the tradition
from which it arises, participants writing haiku poetry about a calming nature
topic reported increased spiritual meaning. However, the findings regarding
physiological symptomatology were not as clear. In contrast to the overall
decrease in physiological symptomatology across both groups, the haiku
group writing about a nature topic failed to report decreased physiological
symptomatology from just after the writing intervention to the 4-week follow-
up, a trend that was significant compared with the control group’s decrease. In
summary, these findings suggest that creative writing such as haiku poetry can
be beneficial, and that while there are certain results that accrue simply from
writing haiku, others are topic dependent.
Thus, haiku poetry appears to hold promise as a writing intervention, and
part of its value may stem from the opportunity it presents for creative expres-
sion. The goal of the present study was to consider whether writing haiku poetry
in the context of the writing paradigm would provide an alternative to writing in
narrative form about strongly positive or negative emotional experiences of a
personal nature.
Present Study
Three issues regarding the potential benefits of writing haiku poetry were
addressed in this research. First, the present study intended to build upon the
findings of a previous study (Stephenson & Rosen, 2013) by refining the control
condition and asked directly whether writing haiku poetry about even a neutral
topic would lead to significant positive change. In comparing writing haiku
about a neutral topic (Haiku-Control) with writing about the same neutral
topic in narrative form (Narrative-Control), it was hypothesized that writing
in haiku form would lead to salubrious change. In the present study, salubrious
change was operationalized as follows: decreases in reported anxiety, depression,
illness orientation, and physiological symptomatology; and increases in reported
happiness, life satisfaction, health evaluation, health orientation, spiritual mean-
ing, and creativity.
Second, the study explored the relationship between increased spiritual mean-
ing and physiological symptomatology in the haiku nature group. In a previous
study (Stephenson & Rosen, 2013), an unusual finding was that in writing haiku
about a nature topic (Haiku-Nature) relative to a control topic (Haiku-Control),
participants reported increased spiritual meaning but a forestalling of the overall
decrease in physiological symptomatology. If in the present study a similar pat-
tern were discovered, it was hypothesized that this would be a result of spiritual
Stephenson and Rosen 43
meaning moderating the relationship between health/illness orientation and
physiological symptomatology.
Third, this study introduced a comparison between writing haiku poetry
about nature, the traditional topic associated with the form, and a negative
life event or trauma (Haiku-Negative Life Event), the most common topic in
the writing paradigm literature. It was hypothesized that writing about nature
would lead to greater salubrious change.
Method
Participants
Participants for this study consisted of 98 undergraduate students at a large
southwestern university who received course credit for participating. The par-
ticipants, 40% male and 60% female, ranged in age from 17 to 27 with a median
age of 18. Seventy-five percent were White/Caucasian, 10% Hispanic/Latino,
8% Asian, 3% Black or African American, 2% Native Hawaiian or other Pacific
Islander, and 2% reported more than one race.
Measures
A group of eight self-report measures were used. The Spiritual Meaning Scale
(SMS; Mascaro, Rosen, & Morey, 2004) is a 15-item self-report inventory that
measures the extent to which a person believes that life, or some force of which
life is a function, has a purpose, will, or way in which individuals participate,
independent of religious orientation. A sample item is, “We are all participating
in something larger and greater than any of us.” Psychometric characteristics of
the SMS show a 1-month test-retest reliability of .84; the internal consistency
was .94 in the present study.
The Creative Personality Scale (CPS; Gough, 1979) was developed from the
Adjective Check List (Gough & Heilbrun, 1983) and constitutes a 30-item check-
list of adjectives designating positive and negative personality characteristics
that have been found to load onto factors associated with creativity. A creativity
measure emphasizing trait aspects of creativity was selected in order to test
whether findings by Djikic and colleagues (Djikic, Oatley, & Peterson, 2012;
Djikic, Oatley, Zoeterman, & Peterson, 2009a, 2009b) regarding exposure to
art would extend to creating it. They have found that exposure to art affects
brief changes in affect that in turn affect brief changes in trait-level aspects of
personality. Adjectives that load positively for creativity include confident, indi-
vidualistic, and reflective; adjectives that load negatively include cautious, con-
ventional, and sincere. Coefficient alpha was .77 in the present study.
The Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin,
1985) is a measure of global life satisfaction consisting of five statements that are
44 Empirical Studies of the Arts 33(1)
rated via 7-point Likert scales. One item on the scale is, “In most ways my life is
close to my ideal.” Coefficient alpha was .89 in the present study, and 2-month
test-retest reliability is .82.
The Subjective Happiness Scale (SHS; Lyubomirsky & Lepper, 1999) is a 4-
item questionnaire of global subjective happiness measured via 7-point Likert
scales. One item asks respondents to indicate where on the 7-point scale they
consider themselves to be, from “not a very happy person (1) to a very happy
person (7).” Another item asks the same question, but in comparison with one’s
peers. Coefficient alpha was .89 in the present study, and the test-retest reliability
average is .72 for samples between 3 weeks to 1 year.
Anxiety and depression were measured using the respective subscales of the
Personality Assessment Inventory (PAI; Morey, 1990). Each subscale includes 24
items; the anxiety subscale (PAIA) demonstrated a coefficient alpha of .91 and
the depression subscale (PAID) was .87 in the present study. A sample item from
the Anxiety subscale is, “It’s often hard for me to enjoy myself because I am
worrying about things.” One question on the Depression subscale is, “Much of
the time I’m sad for no real reason.”
The Pennebaker Inventory of Limbic Languidness (PILL; Pennebaker, 1982) is
a 54-item questionnaire that measures the frequency of self-reported physio-
logical symptomatology. The items include common physical symptoms and
sensations, such as watery eyes, chest pains, headaches, and swollen joints.
The coefficient alpha was .93 in the present study, and 2-month test-retest reli-
ability ranges from .79 to .83.
The Multidimensional Body-Self Relations Questionnaire (MBSRQ; Brown,
Cash, & Mikulka, 1990; Cash, 1994) is a 69-item self-report measure with 10
subscales providing attitudinal assessment of variables relating to one’s body. Of
interest to this research were the Health Evaluation (sample item: “I am a phys-
ically healthy person”), Health Orientation (sample item: “I know a lot about
things that affect my physical health”), and Illness Orientation (sample item: “If I
am sick, I don’t pay much attention to my symptoms”) subscales, which pro-
vided an indication of participants’ subjective experience of health and illness.
This relationship was hypothesized to be affected by the relationship between the
SMS and PILL. The internal consistency for these three subscales ranged from
.86 to .88 in the present study and has been found to have stable factor loadings
for both genders.
Writing Prompts
Participants wrote about one of three topics—neutral, nature, or negative life
event—in either narrative or haiku poetic form. The Narrative-Control group
was modeled after the traditional writing paradigm prompts (Pennebaker &
Seagal, 1999); participants were asked to write continuously about the psych-
ology building hallway. This topic was chosen because all participants in the
Stephenson and Rosen 45
study would be familiar with it, it was concrete, and it constitutes a space in the
same way describing the scene of an experience in nature or of a negative life
event does. The present instructions placed greater emphasis on writing exclu-
sively about the hallway with respect to the five senses to avoid having partici-
pants include events or people in their writing (Stephenson & Rosen, 2013). The
nature group wrote about “an experience you have had in nature that is calming
to you,” while the negative life event group wrote about “an experience you have
had that bothered or upset you.”
Those participating in the study were asked to write continually about their
topic for the full 20 min. The haiku groups were not informed that they were
writing haiku poetry specifically in order to avoid limiting the creativity of their
writing or otherwise priming them to write in particular ways (Smith, Gerkens,
Shah, & Vargas-Hernandez, 2005; Tulving & Schacter, 1990). Instead, they were
given simple rules that would approximate the form of haiku poetry as it is
typically described (Higginson, 1989): the poetry had to be three lines long
and 11 words or less. Additional suggestions were included to help prompt
ideas if needed but were optional. At follow-up, 33% of the participants who
wrote haiku were able to correctly identify the poetic form.
Procedure
The overall structure of the study was as follows: The writing intervention
involved writing for 20 min a day on 3 consecutive days, with questionnaires
filled out at baseline and 3 weeks after the writing intervention. On Day 1,
participants signed the consent form, filled out all the questionnaires, and com-
pleted the first day of writing. Days 2 and 3 continued the writing intervention.
Within 21–28 days after the last writing day, participants returned to complete
all of the questionnaires again.
Up to 20 participants were run at a time. After completing the consent form,
each participant was given a folder that included all the materials for the study,
with separate envelopes for the questionnaires on Day 1 (Baseline) and follow-up,
as well as for the writing interventions on Days 1 to 3 (five envelopes total).
Participant packets were identified by number for confidentiality and randomized
by experimental group (Narrative-Control, Haiku-Control, Haiku-Nature, or
Haiku-Negative Life Event). Thus, multiple experimental groups were run sim-
ultaneously throughout the study, and the researchers were blind to participant
condition. To preserve uniformity, all instructions read by the researcher were
generic and applied to all four experimental groups. The writing instructions
specific to each group were included in the participant materials and were read
individually by the participants. After being oriented to the study by the
researcher and reading their specific writing instructions, the participants were
led through a generic visualization exercise guiding them through each of the five
senses. Participants then wrote for 20 min on each of the three writing days.
46 Empirical Studies of the Arts 33(1)
Results
Examples of participant writing are included in Table 1. One-way analyses of
variance (ANOVAs) revealed no significant differences between groups with
respect to gender or ethnicity. A series of one-way analyses of covariance
(ANCOVAs) with linear contrasts were used to compare groups, evaluating
findings at 3-week follow-up controlling for baseline. The following contrasts
were made: (a) Narrative-Control versus Haiku-Control, (b) Haiku-Control
versus Haiku-Nature & Haiku-Negative Life Event, (c) Narrative-Control
versus Haiku-Nature & Haiku-Negative Life Event, (d) Haiku-Control versus
Haiku-Nature, and (e) Haiku-Nature versus Haiku-Negative Life Event. The
first three contrasts examined the performance of the two control groups, the
fourth concerned the potential replication of a previous finding regarding
the relationship between spiritual meaning and physiological symptomatology,
and the fifth compared two experimental haiku groups writing about different
topics. ANCOVAs were used to assess intervention effects as accurately as pos-
sible, given the significant correlation of each measure with itself over time (see
Table 2). The estimated marginal means are presented in Table 3.
The first concern was to compare the narrative and haiku control groups to
evaluate their performance with respect to a neutral topic. The groups were
compared both directly (contrast 1: Narrative-Control versus Haiku-Control)
and over against the two experimental groups (contrast 2: Haiku-Control versus
Haiku-Nature & Haiku-Negative Life Event; contrast 3: Narrative-Control
Table 1. Participant Writing Examples.
Narrative-control Haiku-control
The walls are blank white, occasionally dotted with fliers of
psychology events. The air is slightly colder than is com-
fortable and the occasional occupant is always quiet and
preoccupiedð
Chair and trashcan,
Around them you bend,
Full room, you stand.
As I walk up the stairs and out to the hallway I see a water
fountain directly in front of me. I also notice that there are
men’s and women’s restrooms to my right and are across
the hall from each otherð
Entrance sign,
Red and white,
Suddenly, out goes its lights.
Haiku-negative life event Haiku-nature
Childhood friend,
I was so oblivious.
How could you hang there?
Power of water
Crashing on rocks—
Beauty of nature.
A packed car.
A packed road.
A pack of nightmares.
Cold ice, snow falling,
Hot coco steam—
Seasons of joy.
Stephenson and Rosen 47
Table 2. Correlations Between Measures.
12345678910
Baseline 1 Subjective happiness 1
2 Satisfaction with life .57** 1
3 Spiritual meaning .42** .36** 1
4 Creativity .20* .05 .09 1
5 Anxiety .33** .28** .14 .25* 1
6 Depression .60** .55** .35** .27** .62** 1
7 Health evaluation .08 .06 .05 .15 .28* .37** 1
8 Health orientation .38** 0.21 .22 .07 .16 .25 0.06 1
9 Illness Orientation .05 .12 .08 .03 .03 .02 .14 .33* 1
10 Physiological symptomatology .06 .04 .06 .07 .37** .40** .52** .12 .06 1
Follow-up 11 Subjective happiness .81** .56** .43** .22* .37** .61** .10 .36** .11 .02
12 Satisfaction with life .56** .80** .32** .07 .34** .58** .05 .19 .02 .02
13 Spiritual meaning .47** .40** .90** .07 .17 .40** .12 .18 .05 0.02
14 Creativity .17 .05 .01 .63** .26* .18 .01 .19 .03 0.12
15 Anxiety .32** .30** .14 .25* .84** .54** .17 .13 .10 .26*
16 Depression .55** .45** .38** .21* .54** .78** .24 .22 .03 .29**
17 Health evaluation .26** .05 .18 .13 .30** .39** .76** .10 .23 .51**
18 Health orientation .33** .21* .22* .09 .14 .27** .01 .79** .22 .12
19 Illness orientation .10 .02 .09 .05 .01 .13 .08 .18 .77** .10
20 Physiological symptomatology .05 .03 .04 .03 .31** .29** .46** .05 .05 .87**
(continued)
48
Table 2. Continued.
11 12 13 14 15 16 17 18 19 20
Baseline 1 Subjective happiness
2 Satisfaction with life
3 Spiritual meaning
4 Creativity
5 Anxiety
6 Depression
7 Health evaluation
8 Health orientation
9 Illness orientation
10 Physiological symptomatology
Follow-up 11 Subjective happiness 1
12 Satisfaction with life .66** 1
13 Spiritual meaning .55** .45** 1
14 Creativity .20* .13 .05 1
15 Anxiety .46** .43** .24* .31** 1
16 Depression .73** .58** .52** .23* .63** 1
17 Health evaluation .21* .04 .12 .20* .27** .34** 1
18 Health orientation .29** .20 .28** .02 .24* .31** .22* 1
19 Illness orientation .17 .10 .12 .01 .02 .14 .07 .28** 1
20 Physiological symptomatology .01 .05 .05 .03 .28** .22* .45** .13 .13 1
Note. All correlations are based on two-tailed tests of significance.
*p<.05.
**p<.01.
49
Table 3. Estimated Marginal Means of Assessment Measures by Group.
Measures Covariate MGroup Mat follow-up SE
SHS
Subjective Happiness Scale
5.22 NC 5.26 0.15
HC 5.02 0.16
HN 5.21 0.15
HNLE 5.26 0.14
SWLS
Satisfaction with Life Scale
25.47 NC 26.33 0.73
HC 25.60 0.82
HN 25.46 0.75
HNLE 25.33 0.73
SMS
Spiritual Meaning Scale
64.34 NC 64.61 1.03
HC 63.48 1.17
HN 64.78 1.05
HNLE 64.54 1.03
CPS
Creative Personality Scale
4.79 NC 4.41 0.52
HC 4.93 0.58
HN 5.89 0.55
HNLE 5.68 0.51
PILL
Pennebaker Inventory of Limbic
Languidness
118.44 NC 112.52 2.30
HC 116.68 2.62
HN 114.45 2.40
HNLE 120.97 2.32
MBSRQ.HE
Multidimensional Body-Self Relations
Questionnaire—Health Evaluation
4.01 NC 4.04 0.13
HC 4.07 0.14
HN 3.98 0.12
HNLE 4.03 0.12
MBSRQ.HO
Multidimensional Body-Self Relations
Questionnaire—Health Orientation
3.33 NC 3.47 0.11
HC 3.53 0.12
HN 3.23 0.11
HNLE 3.27 0.11
MBSRQ.IO
Multidimensional Body-Self Relations
Questionnaire—Illness Orientation
3.20 NC 3.05 0.15
HC 3.28 0.17
HN 2.77 0.14
HNLE 3.15 0.15
PAIA
Personality Assessment
Inventory—Anxiety (T-scores)
62.36 NC 57.55 1.08
HC 58.84 1.27
HN 60.35 1.10
HNLE 60.53 1.09
(continued)
50 Empirical Studies of the Arts 33(1)
versus Haiku-Nature & Haiku-Negative Life Event). In comparing the
Narrative-Control and Haiku-Control groups directly, depression decreased sig-
nificantly in the narrative group, F(1, 92) ¼8.21, p¼.005, f¼.30. The compari-
sons between the respective control groups and the two haiku experimental
groups yielded the following. In keeping with the previous result, Narrative-
Control exhibited decreased depression (F[1, 92] ¼7.04, p¼.009, f¼.28) and
anxiety (F[1, 91] ¼4.74, p¼.032, f¼.23) relative to the experimental haiku
groups. However, creativity increased in the combined Haiku-Nature and
Haiku-Negative Life Event groups, F(1, 89) ¼4.50, p¼.037, f¼.22. No signifi-
cant differences were found in comparing the Haiku-Control group with the
combined group of Haiku-Nature and Haiku-Negative Life Event.
In a previous study, spiritual meaning was found to increase, while physio-
logical symptomatology was forestalled in the Haiku-Nature group relative to
the Haiku-Control group, from just after the writing intervention to a 4-week
follow-up (Stephenson & Rosen, 2013). This comparison was once again eval-
uated in the present study to determine whether it merits further consideration
and interpretation. When the linear contrast was run comparing Haiku-Control
and Haiku-Nature (contrast 4), spiritual meaning and physiological symptom-
atology were not found to differ significantly as before. The three subscales of
the MBSRQ were originally included in this study to make an analysis of poten-
tial moderation possible were this finding to replicate. Throughout the study,
however, the subscales were analyzed according to the given contrasts, and in
this case, the Illness Orientation subscale of the MBSRQ was found to decrease
significantly in the Haiku-Nature group, F(1, 49) ¼5.10, p¼.028, f¼.32.
Finally, the two experimental haiku groups, Haiku-Nature and Haiku-
Negative Life Event, were compared directly (contrast 5). Here, physiological
symptomatology decreased significantly in the Haiku-Nature group, F(1,
88) ¼3.85, p¼.053, f¼.21.
Discussion
This research sought to examine the potentially salubrious effects of writing
haiku poetry in the context of the writing paradigm. One aim of the study
Table 3. Continued
Measures Covariate MGroup Mat follow-up SE
PAID
Personality Assessment
Inventory—Depression (T-scores)
58.62 NC 54.56 1.30
HC 60.04 1.40
HN 59.46 1.30
HNLE 58.10 1.26
Note.NC¼narrative-control; HC ¼haiku-control; HN ¼haiku-nature; HNLE ¼haiku-negative life event.
Stephenson and Rosen 51
was to refine the use of a control group. Despite using a neutral topic, it was
found in a previous study (Stephenson & Rosen, 2013) that writing haiku led to
significant decreases in both anxiety and physiological symptomatology. To
continue differentiating the role of writing type (narrative vs. haiku) in formu-
lating a control group for this research, two groups wrote about the same neutral
topic in the present study, either in narrative or haiku form. Writing narrative
about a neutral topic led to significant decreases in anxiety and depression rela-
tive to writing haiku. Given that the Haiku-Control group evinced less change
than the Narrative-Control group, it appears that it does have the capacity to
serve as an effective control group when participants are asked to focus exclu-
sively on writing about the physical details of the neutral topic.
Two additional discoveries arose from the sets of analyses aimed at resolving
this issue. Contrary to our hypotheses, writing narrative even about a control
topic led to decreases in anxiety and depression in comparison with writing in
haiku form. These findings regarding the effects of narrative-based expressive
writing are in keeping with those reported in the literature generally (Frattaroli,
2006), though it is unusual to have such an effect arise in response to writing
about a neutral topic. On the other hand, these same comparisons also demon-
strated that writing haiku poetry about nature or a negative life event led to
increased creativity relative to writing in narrative about a neutral topic. This
finding may be related to the manner in which poetry constrains the use of
language, in that finding appropriate expression within the limits of the poetic
form (or tradition) pushes one toward novel language use (Loori, 2004;
Martindale, 1975; May, 1976). However, changes on other variables associated
with positive psychology were lacking: Spiritual meaning, subjective well-being,
and subjective happiness were all nonsignificant in this study.
The present findings also helped clarify the role of physiological symptom-
atology. In a previous study (Stephenson & Rosen, 2013), physiological symp-
tomatology decreased overall in two groups writing haiku about either a neutral
topic or a calming nature scene, yet was forestalled in the nature-writing haiku
group from just after the writing intervention to the 4-week follow-up. In the
present study, physiological symptomatology decreased in writing haiku about a
nature topic relative to writing haiku about a negative life event, in keeping with
the overall trend of decreased symptomatology across the two studies. Thus,
writing haiku about a nature topic has generally tended to reduce physiological
symptomatology. Physiological symptomatology decreased most, however, in
the Narrative-Control group.
A related finding concerned illness orientation. In comparing the Haiku-
Control and Haiku-Nature groups, illness orientation decreased in the Haiku-
Nature group, a finding driven by a decrease for the Haiku-Nature group while
the Haiku-Control and other groups remained constant (Table 3). This result
complements the finding that physiological symptomatology increased in writing
haiku about a negative life event relative to a nature topic. Whereas writing
52 Empirical Studies of the Arts 33(1)
about a negative life event increased participants’ distress, writing about a calm-
ing nature topic led to decreased reactivity regarding illness (Cash, 1994). This
finding is in keeping with the general finding that exposure to nature, even in the
form of images, has quantifiable health benefits (Berman et al., 2008; Walsh,
2011; Wells, 2000). And given that both of these findings occurred while writing
about haiku poetry, it may be that such writing makes one more sensitive to the
topic than composing in narrative. In other words, writing haiku poetry may
involve a greater attunement to the writing topic.
In summary, these findings suggest that narrative writing led to decreases in
anxiety and depression, and haiku writing increased creativity and sensitivity to
topic. There was no indication that writing haiku poetry led to increases in
positive psychological variables such as spiritual meaning or happiness. While
the present findings suggest that writing haiku about a negative life event would
not be appropriate on its own, it might be valuable in combination with narra-
tive writing (Pennebaker, 1997, pp. 99–100; Pizarro, 2004). With respect to the
Japanese tradition, the combination of haiku with narrative writing is known as
haibun (Rosen & Weishaus, 2004). Such a combination might link the heigh-
tened sensitivity or expressiveness of haiku with the integrative capacities of
narrative.
In addition to these findings, creativity was significantly correlated in a
negative direction with anxiety and depression and in a positive direction
with subjective happiness and health evaluation (Table 1). These correlations
support the conception of everyday creativity (Richards, 2007b), suggesting
that increasing creativity provides a buffering effect with both negative and
positive attributes. When considered in the context of the writing groups, nar-
rative and haiku appear to have captured—and highlighted—a particular facet
of the negative correlations. When participants composed in narrative, anxiety
and depression were more likely to decrease, but creativity did not increase;
when they composed haiku, creativity was more likely to increase, but anxiety
and depression were not reliably decreased. The correlations beg the question,
what method of writing would best take advantage of this dynamic? The find-
ings from this study suggest, as have the other studies like it (Floyd, 2003;
Henderson et al., 2007; Pennebaker, 1997, pp. 99–101; Pizarro, 2004), that the
combination of engagement with the arts and the use of narrative might be
ideal. In addition to the benefits of the narrative writing, integrating the arts
into the writing paradigm has increased creativity, participation, engagement,
and even flow.
Finally, the increase in creativity on a measure emphasizing personality traits
provided some support for the notion that, like exposure to art alone, engaging
in art can lead to small disruptions in self-regulation (Djikic, 2014; Djikic et al.,
2009a, 2012). As Djikic has described, exposure to art can lead to fluctuations in
personality, a process that is mediated by emotional fluctuations arising in
response to art. She has argued that these fluctuations in personality or sense
Stephenson and Rosen 53
of self provide an opportunity for growth that has also been associated with
haiku, both as an art form in itself and through its association with Zen
Buddhism (Loori, 2004; Suzuki, 1959). Using different methods and with a
Big-C historiometric sample, Martindale made a similar argument, that in the
process of engaging with their chosen medium, great artists have often repre-
sented in their work what Evelyn Underhill outlined with her five stages of
mystical experience and Jung described as the path of individuation
(Martindale, 1975, p. 194, 1990, p. 327).
Thus, findings from mini-c (Djikic), little-c (present study), and Big-C
(Martindale) can all be conceptualized as providing opportunities to engage
with the process of psychological growth and development. As Djikic (2014)
has noted, however, people respond differently to such dysregulation. The
default response is to return to one’s baseline, which reintroduces regulation
faster but with little or no growth. The literature concerning the use of creativity
in the healing process (Forgeard, 2013; Richards, 2007a; Rosen, 2002) has sug-
gested that in such cases, individuals turn to art to begin working with a pain or
suffering that may at first be beyond the grasp of words. Henderson et al.
(2007), for example, found that drawing mandalas led to significant decreases
in traumatic symptomatology.
The Place of Poetry
But what about when one is not dealing with a major illness or trauma? Diener
et al. (2009) have discussed the importance of experiencing more positive affect
than negative affect in daily life to achieve happiness. But as Wallace Stevens
noted, “The purpose of poetry is to contribute to man’s happiness” (quoted in
Gioia, 1992, p. 19). In the west, engaging with the arts is often enough associated
with Big-C creators and mental illness. But in the Japanese tradition of way-arts,
engagement with arts like haiku and ikebana (flower arrangement) are under-
stood to be a practice and thus a more natural part of daily life (Loori, 2004;
Suzuki, 1959).
Of course, there are advocates for such daily creativity in the west as well
(e.g., Fox, 2004; Richards, 2007b). A case might be made for such engagement
by considering Diener’s emphasis on regular positive affect in combination with
Fredrickson’s broaden and build theory of positive emotion (2001): Being
exposed to or engaging with the arts might provide an opportunity to foster
positive affect that would broaden and build. The present study did not support
this contention directly, as the positive psychology variables other than creativ-
ity did not change significantly in any group. The findings did, however, suggest
that writing haiku increased creativity, which in turn correlated significantly
with subjective happiness (Table 1). Participants also reported greater enjoyment
of the Haiku-Nature writing than the other groups (56% vs. 35% in each of the
other groups). In addition, the present study suggested that writing haiku
54 Empirical Studies of the Arts 33(1)
increased participants’ sensitivity to the topic. Thus, choosing to write creatively
about a topic like nature or joy might provide a means of cultivating subjective
well-being.
Gioia (1992) has written about the disappearance of a public forum for
poetry, and with it the opportunity for poets to write meaningfully about
events occurring in the world. Instead, they are increasingly pushed toward
mining their own psyches in ways that lead to increasingly private and poten-
tially abstruse uses of language, in the manner Martindale’s research described
(1975, 1990). Nevertheless, there is a power to such public engagement when it
occurs. A recent western example with haiku has been Honku (Naparstek, 2003),
which began when a Brooklyn resident became so upset with the blaring horns in
traffic outside his apartment that he began posting haiku—honku—as an alter-
native to his original impulse to retaliate with eggs or garbage. He wrote of how
his initial creative response led to a movement that dramatically reduced the
honking in his neighborhood. Rather than continuing to relegate the arts to
therapeutic contexts and Big-C contributions, perhaps the opportunity lies
more in reconceptualizing the manner in which we engage them.
Limitations and Future Directions
This study was limited in several ways. The sample for the present study
involved college students largely unfamiliar with writing poetry, let alone
haiku. It may be, however, that more experienced writers would better capture
the active ingredient involved, or be more sensitive to its effects. Also, partici-
pants wrote in small groups in a university classroom. In contrast to the trad-
itional manner in which haiku was written on the spot, often in nature, such a
practice may not be optimal. Finally, this study relied exclusively on self-report
measures.
With respect to future studies, in addition to continuing to explore the rela-
tionship between haiku and narrative, the creativity of participants’ haiku might
be rated objectively and this considered with respect to other variables.
Mindfulness could also be considered as a variable in order to explore the con-
nection with creativity (Djikic, 2014; Runco, 2006, p. 373).
Humorous haiku (senryu) might also be considered, which forms a distinct
body within the haiku tradition. Empirically, humor has been linked with
increased hope (Vilaythong et al., 2003); and spiritual meaning, which was
found to increase in one group writing haiku poetry in a previous study
(Stephenson & Rosen, 2013), has been found to buffer against depression and
increase hope (Mascaro & Rosen, 2006). Hope, in turn, has been found to be a
buffer against anxiety and depression (Arnau, Rosen, Finch, Rhudy, &
Fortunato, 2007), and spiritual meaning and hope have also been found to
counteract genetic susceptibility to stress-related depression in certain groups
of medical students (Rosen et al., 2010).
Stephenson and Rosen 55
Another possibility that might better reflect the experience of haiku would be
to have participants write haiku in response to specific environments, rather than
visualizing their own. That is, instead of having participants close their eyes and
visualize a scene, they could be presented with a picture of a nature scene, for
example, and asked to write haiku in response to the given image. Alternately,
participants could write haiku directly in nature.
While there appear to be significant differences between writing narrative and
haiku, further research will be required to distinguish their respective strengths
and determine how haiku, known in the Japanese tradition to be healing (Rosen
& Weishaus, 2004; Suzuki, 1959), might best be framed as its popularity con-
tinues to spread it around the world (Blasko & Merski, 1998).
Acknowledgments
The authors would like to thank the following individuals for their help in collecting and
processing data for this research: Janna Brancazio, Amanda Clinard, Amanda Craven,
Amanda Edwards, Chantell Frazier, Richard Higgins, Ashley Hill, Whitley Lanier,
Christen Nixon, Ashley Olson, and Arzu Shams.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, author-
ship, and/or publication of this article: Preparation of this article was facilitated by a
Japanese Government (MEXT) Scholarship awarded to the first author.
Note
1. Reprints of the article are available from the first author upon request.
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Author Biographies
Kittredge Stephenson is currently a postdoctoral fellow at The Menninger Clinic,
Baylor College of Medicine. As a Japanese Government (MEXT) Scholar, he
spent a year and a half in Kyoto researching Japanese culture and has published
haiku and renku poetry. He holds a PhD in clinical psychology from Texas
A&M University and a MA in eastern classics from St. John’s College.
David H. Rosen is currently an affiliate professor in psychiatry at the
Department of Psychiatry, Oregon Health & Science University. At Texas
A&M University, he was the first holder of the McMillan Professorship in
Analytical Psychology, Professor of Psychiatry & Behavioral Science, and
Professor of Humanities and Medicine. He is the author of several books,
including The Healing Spirit of Haiku with Joel Weishaus. He holds a MD
from the University of Missouri.
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