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An intriguing and encouraging development in therapeutic writing

(This blog post is available both as a PDF file and as a Word doc - you may need to 'save' the latter before you can open it) 

"You cannot protect yourself from sadness without protecting yourself from happiness."  Jonathan Safran Foer

"No man was ever wise by chance."    Lucius Seneca  

I'm a fan of therapeutic writing and this website is dotted with blog posts and handouts that document my exploration of this subject.  Examples include a series of four posts about Jamie Pennebaker's lecture at last year's BABCP conference starting with "Jamie Pennebaker, expressive writing & emotional suppression", a further series of three starting with "Writing (and speaking) for resilience & wellbeing: introduction" and a description of how I have been teaching therapeutic writing on the "Life skills for stress, health & wellbeing" course that I run.  The family of techniques covered by the umbrella term "therapeutic writing" constitute a delightful cluster of self-help methods that it's great to be aware of and to be able to use appropriately.

As you can imagine, I very much keep my eye open for good emerging research in this area.  I was therefore intrigued and excited by Rebecca North & colleagues' recent paper "Finding happiness in negative emotions: An experimental test of a novel expressive writing paradigm".  The abstract reads "Using an experimental writing design, this study pitted a novel emotion regulation strategy, integrating psychological acceptance and positive reappraisal, against two established strategies for increasing psychological well-being: emotional disclosure (Pennebaker, 1997) and positive reappraisal (DeNeve Gross & John, 2003). 315 undergraduate students wrote on four consecutive days about the biggest problem in their lives and were randomly assigned to use one of the three strategies: (1) emotional disclosure, (2) positive reappraisal, or (3) acceptance + positive reappraisal. Results indicated that the integrative condition led to optimal emotional well-being outcomes at post-intervention, including: greater happiness and positive emotions, marginally fewer negative emotions, and greater overall psychological acceptance. Findings indicate that accepting one's negative emotions and then trying to seek out positives might be an optimal strategy for building happiness." 

"Psychological acceptance" was particularly improved by this writing intervention.  It was assessed using the "Acceptance & action questionnaire (AAQ)", a widely used 9-item measure of one's ability to "accept" difficult experiences and still "act" effectively.  The questionnaire is available from this site both as a Word document and as a PDF file (you may need to save the Word doc on your computer before you can open it).

Participants in the acceptance + positive reappraisal group were told that, for the first two episodes of writing, they would be focusing on negative feelings, and that for the second two episodes of writing they would focus on positive feelings.  The instructions were as follows:  "You will be writing about the following topic for the first two days of the writing experiment.  Please think of the biggest problem or most difficult challenge you are having in your life right now.  Think about it for a few moments.  Now, focus on the painful or negative feelings you have that are related to the problem. Really get into it and allow yourself to explore the most painful feelings associated with the issue.  Try to accept them and not to push them away.  Please write about these negative feelings you have that stem from the problem.  Please write ONLY about the negative feelings.  Please DO NOT write about any positive things that could come from the problem.  Write about the painful feelings you have because of the problem in as much detail as you can, and please write without stopping for the entire 20 min.  As you write, do not worry about punctuation or grammar, just really let go, and write as much as you can about the negative feelings that you have in relation to the biggest problem you are having in your life right now.  On the third and fourth days of the writing experiment, you will be writing about positive things that could come from your problem, so please ONLY write about the negative feelings you have because of the problem right now."

Then instructions for the next two episodes of writing were: "You will be writing about the following topic for the last 2 days of the writing experiment.  Please think of the biggest problem or most difficult challenge you are having in your life right now.  Think about it for a few moments.  Now, focus on the positive aspects of this problem and on positive things that might end up happening because of this problem.  Really get into it and try to imagine all of the positive things that could come from this problem.  Please write about these positive aspects of the problem and the positive things that could come from the problem.  Please write ONLY about the positive.  Please DO NOT write about any negative feelings or consequences.  Write about the positive aspects of the problem and the positive things that could come from the problem in as much detail as you can, and please write without stopping for the entire 20 min.  As you write, do not worry about punctuation or grammar, just really get into it, and write as much as you can about the positive things that could come from the biggest problem you are having in your life right now."

This is good stuff and well worth using.  Looking more broadly at other research findings in the field of therapeutic writing, we can be confident that these very specific North et al instructions (see above) can almost certainly be adapted, without loss of benefit, in a number of ways.  It may well be worth writing about the current "biggest problem or most difficult challenge you are having in your life right now".  It's likely also to be valuable simply to write more generally about current stresses.  Looking back and writing about difficult experiences from the past is also a useful route to follow, and it can even be helpful to write about daunting future challenges that one is facing.  See "Writing can help past, present and future concerns" for more on this issue.  The time interval too can be adapted - see the post "Expressive writing & timing issues" - so it's likely to be fine to write on four occasions separated by a variety of different times.  For example one could squeeze all four episodes of writing into a single day or write weekly for a month or so.  Similarly, there's no great magic about the 20 minute duration, so one can be comfortable writing for a bit longer or a bit shorter if this feels right.  Even the instruction to write continuously can be adapted as long as one gets the material down on paper - occasionally pausing to feel inside and contact deeper emotions and thoughts is likely to be well worthwhile.

There are further handouts, giving fuller instructions about expressive writing, on the "Life review, traumatic memories & therapeutic writing" page of this website.  There is more on the very important skill of "finding positives" at "Reappraising reappraisal" and an exploration of "post-traumatic growth" including the useful "Posttraumatic growth inventory" at "Writing (& speaking) for resilience & wellbeing: personal growth".  The overall message is that this integrated form of writing about negative and then positive aspects of a difficulty is a sensible, helpful tool to have in one's stress management kitbag.

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