I was ugly crying. I was also stabbing and gouging the pages of my journal.
More than tears & paper-mutilation
I was indeed journalling, but this was no ordinary ‘journaling’ that I did for 20 minutes each morning. I mean, I wrote stuff too – I wasn’t just mutilating paper. But the writing was not regular writing – it was ‘expressive writing.’
It was one of several tools I used to survive my PhD. And not only did I survive, I was awarded $4,000 by my university for submitting a timely quality thesis. More importantly, it’s a thesis that I’m bludy proud of. Thank you.
Bizarre – yes! But …
This intense journalling may sound bizarre, but it’s the stress-reducing, immunity-boosting technique I ‘prescribe’ most frequently to humans – including myself.
It’s simplicity itself and is called ‘emotional disclosure’ or ‘expressive writing.’ It’s a technique that involves writing about painful life events.
I appreciate expressive writing may not sound like fun. But it’s a simple, brief, psychology tactic that delivers powerful clinically-proven results. I’ll give the specific instructions after I explain the evidence supporting its effectiveness.
Emotional roller coasters
The subjective, or self-reported, benefits of expressive writing have long been known. The process tends to be a bit of an emotional roller coaster that ends well— not unlike an effective counseling session. While people typically report feeling upset during and immediately after writing about painful events (understandably) the upset quickly subsides, leaving them feeling better than before they started writing.
But we no longer need to rely on subjective self-report alone to assess the benefits of expressive writing. We now also have objective physiological data – physiological measures of immunity from revolting research.
Effects on immunity?
There’s a growing body of research exploring the impact of expressive writing on immunity. In one such study, healthy older adults were randomly allocated to write about either upsetting life events (expressive writing) or non-upsetting daily activities (non-expressive). (You can read the actual journal article if you are interested.) An example of NON-expressive-writing being, “I woke at 6.30am and had porridge for breakfast.” Exciting stuff.
Assessing immune function via wound healing
While the study did include subjective self-report measures, it also included objective measures of immune function. After the participants had done the writing task, a punch biopsy—a plug of skin—was taken from their upper arms to assess immune function via wound healing rates. I saw the close-up photos of the punch biopsies. Gross.
Dramatic differences in healing rates
Grossness aside, 11 days after the punch biopsy there were dramatic differences in healing between the two groups.
In the expressive-writing group, 76 % of people’s arm wounds were fully healed. In contrast, in the non-expressive ‘daily activities’ writing group, only 42 % of people’s wounds were fully healed. That is a HUGE effect size!
(Incidentally, aside from the type of writing [expressive or non-expressive] there was one other thing that predicted faster wound healing – and that was more sleep in the week before the punch biopsy.)
Only 60 minutes for boosted immunity!
The differences in healing rates between the two groups are impressive, but there was something else about this simple ‘therapeutic’ intervention that blew me away. And that was, to achieve the superior healing effects that they did, the expressive-writing participants only wrote for 20 minutes on three consecutive days. That’s only 60 minutes!
How does it work?
The jury’s still debating exactly how writing about distressing events boosts mental and physical health.
It’s plausible that the physical act of writing is helpful. Rumination—where thoughts go around and around in your head without resolution—is a characteristic of stress and anxiety. But while we may mentally ruminate for hours, it feels silly ruminating on paper (when I was eight years old, the school principal ordered me to write 100 lines of “I must not run in the corridor”—and I did feel silly, writing my lines in a toilet cubicle so no one would see me).
Additionally, writing thoughts down seems to automatically shunt us from endless repetition of stressful thoughts into problem-solving mode.
Releasing immunity-suppressing stress?
As chronic stress is known to suppress the immune system, it’s also likely expressive writing boosts immunity via releasing and processing stress. It’s also possible that, compared with ‘talk therapy,’ expressive writing has a greater therapeutic impact because it involves more of the brain, specifically the motor-control parts that are manipulating the pen, pencil, or keyboard.
Stigma around therapy
And, of course, many people, for reasons ranging from stigma to lack of cash to lack of access to quality therapists, won’t or can’t go to an actual therapist.
Regardless of how expressive writing works to boost immunity —it works. I still do it regularly and you may wish to also. The evidence is compelling for its ability to substantially boost mental and physical health—and it’s free.
If you are interested in giving it a go, here are the standard instructions from the clinical trials:
“Write about your deepest thoughts and feelings about a traumatic, upsetting life experience. If you haven’t had a traumatic experience, then write about a significant life-changing event. Ideally write about something you haven’t discussed in great detail with anybody else.”
FAQ: How long do I write for?
This is a common question. As for the ideal amount of time and frequency to write, the jury’s still out on that also. Most studies involved two or three 20-minute writing sessions.
I suggest do whatever you feel like. While I did 20 minutes of expressive writing daily over several months to help me finish my PhD – in other words I made it a habit – now I just do it whenever I feel the need. So don’t worry about how often you should write or how long you should write for. I’m confident even a few minutes of expressive writing helps at least a little, and maybe helps a lot.
Incidentally, in the study I describe in detail above, the expressive writing was done before the punch biopsy wound was administered. However, there’s even more recent research showing that expressive writing done soon after the injury/surgery is still effective.
But it feels like another chore!!
I’ve found that while many people like the idea of expressive writing, some find it off-putting. It can feel like having yet another thing on their ‘Things To Do’ list. In a busy life, expressive writing, regardless of benefits, may feel like another chore.
Easy solution for the time-poor …
I have an easy solution. Just try setting a timer for a small amount of time – a small non-threatening amount that feels ‘do-able.’ Maybe 10 minutes, even 5, and see how you go.
I had one client like this. She had awful family abuse in her past, had never seen a therapist before, and – as she was a workaholic – also felt time-poor. But she agreed to set a timer and try expressive-writing for 10 minutes.
Emo-tears are awesome
She later told me she’d ended up writing for hours – into the small of the night – crying her eyes out (which is great – emotional tears contain the stress hormone cortisol in a way that onion-tears don’t). Afterwards she felt drained – but in a good way. Those painful emotions had been festering inside her for a long time.
Do I need to keep my expressive writing?
Sometimes people wonder if they should keep their expressive writing. And the answer is: No you don’t.
Some people worry about their family finding and reading their expressive writing. However, as the research suggests there is no benefit to re-reading your expressive writing, you might as well get rid of it.
A colleague of mine – and clinical health psychologist – Teresa Nagel – ran a study to assess if there were any benefits to re-reading expressive-writing. One group in her study re-read their expressive-writing from the day before, prior to continuing to write that day. In contrast, the second group didn’t re-read their previous day’s expressive writing.
Does re-reading expressive writing help?
Teresa was looking to see whether re-reading the content made any difference to emotional processing of the event. However, no differences were found between the two groups – suggesting its fine to throw away your expressive writing efforts. If typing on a computer, as Theresa’s participants were, you could simply delete it (just don’t be typing any state secrets anywhere that is possibly recoverable!!) Or, if you are writing on paper, as I tend to do, you can burn it – if it is safe to do so.
In fact I know several therapists who advise burning such writing. However, if burning is not a safe option, it’s fine to just dispose of it any old way.
Expressive writing is a wonder-tool. Not only is it practically free, it has multiple benefits (and no known adverse effects). As well as boosting immunity (not the worst thing in the time of Covid!) and being an excellent PhD survival tool, its provided me with some life-altering epiphanies – which you can read about in my most embarrassing blog post to date: I wanted a trophy boyfriend
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