How journal writing can make you healthier

Keeping a reflective journal can have positive effects on your health and well-being

How journal writing can make you healthier

Source: Best Health Magazine, November/December 2009

Alternative-healing proponents have long made the connection between creative expression and health (think of the popularity of art and music therapy). Now there’s scientific evidence that journal writing, too, may be beneficial to your health.

Evidence that writing heals

Studies suggest that emotional or expressive writing can reduce high blood pressure, enhance immune function, decrease the severity of asthma and arthritis symptoms, promote wound healing, increase AIDS patients’ white blood cell counts and even help young people quit smoking. A study in the June 2008 Journal of Pain and Symptom Management reported that a group of cancer patients, who spent at least 20 minutes once a week for three weeks writing a story about how cancer affected them, experienced less pain and reported higher levels of well-being the more emotionally revealing their stories were.

How writing therapy works

None of this would surprise Isa Nevsky in Toronto. A diagnosis of Stage 4 colorectal cancer led this 57-year-old former nursery-school teacher and mother of three sons to a variety of alternative healing methods, including yoga, meditation and art therapy. Never a confident writer, Nevsky has nevertheless found journal writing to be one of the most important therapies in the 14 years since she was told she had just six weeks to live. This was especially true after she joined ‘Writing for the Health of It,’ a program for cancer patients and their families provided through Wellspring, a network of cancer-support centres.

Instructor Ariella Damelin, who did her doctorate in education with a focus on narrative inquiry, provides a variety of writing exercises for participants to work on each week for eight weeks, culminating in a personal writing portfolio. None of Damelin’s exercises, however, involves writing about being sick. Prompts such as ‘write about a book that changed  your life’ or ‘write a letter to yourself as a child”without regard to grammar, spelling or the ‘inner critic’‘lead to narratives that may or may not touch on illness, but often uncover meaningful old stories and relevant new perspectives. ‘I’m interested in the power of story to create a feeling that you have a life that’s worth living, that you are not defined by your cancer’it’s only one part of you,’ explains Damelin.

Nevsky describes the results as magical: ‘I saw a side of me that I didn’t know I had. Damelin’s topics always brought out something you weren’t expecting. I’ve never seen so many tears of sadness end up as tears of joy and laughter.’

The science behind writing for health

James Pennebaker, chair of the department of psychology at the University of Texas at Austin and a pioneer in the study of writing as a healing tool, says he’s not interested in whether journal writing makes people ‘feel nice,’ but only in empirical evidence of its ability to improve physical well-being’and he’s found that in abundance. His research involves writing about trauma. While popular theories hold that disclosing emotions and secrets is always beneficial because repressing them is hard work, Pennebaker’s research doesn’t support a public confessional approach. He favours writing that isn’t done for an audience. In some of his experiments, the participants even benefited from writing that was thrown out without having been read by anyone else.

Private vs. public writing

Pennebaker believes there’s something about the act of writing itself that helps us change how we feel about our lives. And he’s discovered that certain forms of writing may be better than others for the healing process. As with talk therapy, it appears that imposing some structure on writing and building a new narrative’as opposed to rehashing the same old stories and feelings over and over again’provides a perspective on and distance from life events that help us figure out what those events mean and how to handle them differently. In fact, writing only the details of traumatic events or writing only about our emotional responses can actually do more harm than good. It’s the combin­ation of the two that seems to boost health. And he has written a workbook with exercises that anyone can do on their own with no need to share.

Writing therapy doesn’t work for everyone, says Pennebaker. There’s no evidence that daily writing over prolonged periods is fruitful, either; he suggests using it on an as-needed basis. He’s now studying what happens when writers change perspective by shifting from first person to third person (‘I’ to ‘she,’ for example), based on the theory that the entirely self-absorbed writer may gain little insight, but that we may be able to better understand our tribulations by looking at the world through the eyes of others who were involved.

Dr. Allan Peterkin, a psychiatrist at Toronto’s Mount Sinai Hospital, takes a more public approach. He helps run a writing therapy group for people living with HIV/AIDS and asks participants to use the same narrative tools that professional writers employ‘such as specific detail, strong verbs and dialogue’to write a non-fiction story with a beginning, middle and end. No one is pushed to address issues they find too painful to face. ‘We encourage them to write for an im­agined audience to flush out the story and make it fully comprehensible to others as well as themselves,’ he says, adding that participants read their stories aloud to the group, and have published them in a book.

Blogging for health

Public or private, the key is finding what works. Tasha Westerman, a 35-year-old human resources professional and mother of a toddler in Calgary, has been battling breast cancer while her husband deals with a brain tumour and her best friend with leuk­emia. She tried writing in one of the many blank journals people gave her after her diagnosis, but it would never stick. ‘Writing to myself didn’t have much meaning,’ she says.

Her sole motivation in starting a blog was a practical one: ‘I felt a lot of pressure with so many supporters always calling the house or emailing, wanting to know every day how things were going.’ Her blog relieved that pressure, but it proved rewarding in other ways, too.

‘When one has cancer, the information flows in quickly and decisions need to be made even faster,’ Westerman explains. ‘I found blogging was a great way to collect my thoughts and summarize what had happened at medical appointments, and to reaffirm the decisions I’d made.’ What’s more, emotional support poured in on her comments page, not only from loved ones but from strangers. And though she didn’t set out to expose her emotions, they came out anyway. ‘When I know I’m writing to others, I get more out of it,’ Westerman says. ‘I learn new things about myself or how I feel about something because it does just flow out of me. It’s a way of gaining perspective on what’s going on.’

Admitting she would once have been the first to pooh-pooh the notion that blogging could yield health benefits, Westerman is now convinced that because it reduces her stress levels, writing for her online audience is one more thing that’s keeping her alive.

Try this exercise:

In Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval, Pennebaker suggests this simple exercise for anyone bothered by a current stressful event or past turmoil.
‘ Write for 20 minutes per day for four days.
‘ Write about a major conflict or stressor in your life, something personal and important; you can write about the same one four times, or write about different ones.
‘ Write without stopping; don’t worry about spelling and grammar.
‘ Write this for your eyes only.
‘ If writing about something makes you unbearably upset, stop.

Don’t expect to feel better immediately (you may feel worse), but do take note of changes in yourself in the weeks to come.

This article was originally titled "Words to heal by," in the November/December 2009 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.

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