The Research on Expressive Writing: Writing about Trauma

In 1983, James Pennebaker, a psychologist, then at Southern Methodist University, conducted, along with one of his graduate students, Sandra Beall, a study of forty-six college students. Students in one group—the experimental group—were instructed to write continuously for fifteen minutes about the most upsetting or traumatic experience of their lives.

Their instructions included the following:

In your writing, I want you to discuss your deepest thoughts and feelings about the experience. You can write about anything you want. But whatever you choose, it should be something that has affected you very deeply. Ideally, it should be something you have not talked [about] with others in detail. It is critical, however, that you let yourself go and touch those deepest emotions and thoughts that you have. In other words, write about what happened and how you felt about it, and how you feel about it now.

In essence, these students were being invited to write about a time when something had fallen apart.

Students wrote sitting alone in a small cubicle in the psychology building. They wrote on four consecutive days and did not sign their names to their pieces. These were not students who had been recruited because they were experiencing emotional or physical problems. These were ordinary college students recruited from introductory psychology classes. They wrote about the divorce of parents, about loss and abuse, about alcoholism and suicide attempts. They wrote about secrets. And in interviews conducted after finishing the four writing sessions, students actually reported feeling worse than they had before the writing.

But four months later, these same students, compared to students who had written about trivial topics, reported improvements in mood and in outlook on life, and, perhaps most surprisingly, improvements in their physical health. When data came in from the student health center, it revealed that this same group of students had in fact visited the student health center for illness, on average, only half as often as their peers.

This particular kind of writing—writing one’s deepest thoughts and feelings about trouble—is sometimes called expressive writing. And it’s the kind of writing about which much of the research on writing and health has been conducted. Since that early study in 1983, expressive writing has been tested in a wide range of settings. It’s been shown to improve self-reported health, psychological well-being, grade point average, and re-employment after lay-off. It’s been shown to benefit women with breast cancer, to decrease blood pressure in people with hypertension, to mitigate pain and fatigue in those with fibromyalgia, and to improve markers of immune function for those with AIDS.

In an afterward to The Writing Cure, a compilation of research and theory published nearly twenty years after Pennebaker’s first study on expressive writing and health, he reflects on some of the implications of the body of research in the field.

He writes:

All of the evidence would suggest that writing brings about a general reduction in biological stress. That is, when an individual has come to terms with an upsetting experience, he or she is less vigilant about the world and potential threats. This results in an overall lowering of defenses. . . . Given the broad range of improvements in health outcomes, it would be prudent to conclude that writing provokes a rather broad and nonspecific pattern of biological changes that are generally salutary.

I find this research on writing and health a reason for hope. It suggests that though bringing painful fragments of experience to the surface through the process of writing may feel painful in the short term, there’s a potential for a tangible benefit in the wake of this pain. That is, writing about such fragments can lead to health benefits on the other side. At the same time, I feel like each person (of course) gets to make that choice: if and when to touch on painful fragments. I, for one, never push people to do this before they’re ready. I’ve come to learn that most people have a kind of inner sense or knowing that lets them know when they’re ready to write about trouble. And if they’re unsure? Well, one way to deal with being unsure is to write the question at the top of a blank sheet of paper. The question itself can become a kind of title: Is Now a Good Time to Write About Falling Apart? Is Now a Good Time to Touch Grief? And then a person can write and write and see what comes—-

For sources on this brief review of writing about trouble, I used Opening Up, by James Pennebaker, and The Writing Cure, edited by Stephen Lepore and Joshua Smyth.

See also an index of research on writing and health from this site, with articles on nine additional studies, here.