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How Expressive Writing Can Improve Health

Updated: Dec 5, 2023

Written by Tracey O'Connell, MD, Certified Expressive Writing Facilitator

A woman writing by hand in a notebook
Expressive writing is more than journaling

What makes you an ideal candidate for expressive writing?

Maybe you have something you're thinking about or worrying about way too much. Perhaps you've deliberately tried to not think about this series of events or event. But you're dreaming about it at night, or it's affecting your life in an unhealthy way. It's interfering with your ability to calm down. Maybe you find yourself ruminating about it. Maybe it's leading you to addictive or compulsive behaviors. How much would you like to rid yourself of this mind-sucking plague? What would be possible for you if you could transform this event and heal yourself? What if it only took a commitment, a pen and paper, and a total of 60 minutes? Would you do it?

Why is expressive writing gaining so much attention now, after so much time?

I was so thrilled to see that Andrew Huberman, Ph.D., a neuroscientist and tenured professor in the department of neurobiology, psychiatry and behavioral sciences at Stanford School of Medicine, just launched a 90-minute podcast episode entitled, A Science-Supported Journaling Protocol to Improve Mental and Physical Health on his Hubermanlab podcast.

Huberman has made numerous significant contributions to the fields of brain development, brain function and neural plasticity, which is the ability of our nervous system to rewire and learn new behaviors, skills and cognitive functioning.

Although the form of journaling he discusses, known as expressive writing, has been around since the mid-1980's, and undergone rigorous scientific research and validation, it hasn't been promoted to the wider public until now. What's wonderful about Huberman discussing expressive writing is that he digs into the latest science and brain research discoveries about HOW and WHY expressive writing can improve health. Many people scoff at the utility of journaling, seeing it as a "soft skill" or "mindfulness exercise" without being equipped with faith in an intentional writing program designed to actually reconfigure and heal past lived difficulties. With the popularity of Andrew Huberman and the depth with which he delves into the research, I'm excited for listeners and others to be further informed and encouraged to take part in this free, powerful technique. I'm also a Certified Expressive Writing Facilitator so, naturally, I want people to know it's value and experience it themselves.

What's it like to experience expressive writing firsthand?

My first exposure to how expressive writing can improve health was in 2017. I'd just left a toxic work environment and was trying to determine next steps. While waiting to be credentialed to work from home as a radiologist, I stumbled upon a course offered locally at Duke Health and Wellness Center entitled, Transform Your Health: Write to Heal. I'd always found writing intimidating, but I was intrigued by the title. I had things I needed to heal. Lots of things. I felt broken and lost. I wanted to be transformed, to heal. I signed up.

The instructor was John F. Evans, a gentle soul who had trained with James Pennebaker, the founder of expressive writing and the Pennebaker Protocol. The ten of us in class were invited to write by hand for 15 minutes about the most difficult, even traumatic or possibly non traumatic but still very significant emotional experience we could recall from our entire lives. He assured us that no one would see what we wrote. We could even tear it up at the end. But we had to write without stopping for the entire 15 minutes, without paying attention to grammar, punctuation, or sentence structure.

We were to write about the details of a significant emotional experience as we remembered it now. How the event happened, who else was involved, what we were feeling and thinking as the traumatic/stressful event was happening as specifically as possible. We were encouraged to really let go and explore our deepest emotions and thoughts, maybe tying tying the experience to childhood, to relationships with parents or siblings, people you've loved or love now or even your career or schooling; to who you have now become, who you've been in the past, and who you'd like to become. He reminded us that our writing was confidential and would not be shared with others in the room or elsewhere.

We wrote about the same significant emotional experience for a total of four sessions, 15 minutes each. After each session, we also answered a series of questions known as a "post-writing reflection" (PWR) to check in with ourselves and see how we were doing. The PWR has 5 questions, the first four of which are to rate ourselves on a scale from 1-10, 1 being "not at all" and 10 being "a great deal." The questions are:

  • To what degree did you express your deepest thoughts and feelings?

  • To what degree do you currently feel sad or upset?

  • To what degree do you currently feel happy?

  • To what degree was this writing valuable and meaningful for you?

The last request was to briefly describe how your writing went so you may refer to it later.

Is expressive writing re-traumatizing?

Admittedly, the exercise wasn't easy. To revisit a traumatic experience again and again hardly seems like a good idea. Many people who hear about how expressive writing can improve health want to improve their mental and physical health but can't imagine willingly reliving the experience, much less write about it on four different occasions. That's certainly how I'd felt. But then I recognized how much time I was already spending in my head, preoccupied with the experience that was haunting me. Even significant experiences that happened long ago can remain in our brains and bodies long after an event has passed, "trapped" in our tissues and neural networks. Such emotion, when not expressed, doesn't go away. It only wreaks havoc in other ways through our mind-body connection, our relationships with others, with ourselves, with our bodies. I didn't want this to continue. I wanted to liberate the emotions and make meaning out of what had happened, dismantle its power over me. The expressive writing work was so healing for me, I decided to work with John F. Evans again, four years later, to become a Certified Expressive Writing Facilitator.

Not surprisingly, it's normal to feel upset or sad after using expressive writing. It's also been shown that it's not a good idea to write about a traumatic or upsetting event right after it's happened, as this can be re-traumatizing. It's safer to write about something that you've had time to consider and attempt to process. Still, it can be hard to get "jazzed" about bringing up the past or the hard feelings around an unpleasant event. The good news is that these feelings dissipate within a few hours after each writing session. Before writing, participants are reminded that the event is not currently happening at the moment of writing.

How is expressive writing facilitated by writing with others?

One of the benefits of doing this type of work with another is not only the accountability- actually sitting down and doing the writing rather than thinking about doing the writing or, as we say in the South, "fixin' to get ready to do the writing"- but because there is healing energy in the shared experience. Each is going through something difficult and private, and they're doing it together. Expressive writing can improve health by overcoming the loneliness that each of us feels in our experiences. Though the circumstances are unique and the emotions individualized, it's meaningful to be with another who is also going through something difficult. That connection, even when unspoken, is healing. Being with another in a trusting environment provides a form of psychological safety which wasn't present during the initial event.

"When we transfer a difficult story from emotions into words, we can work with it. Once a story is tangible, it is malleable. It is ours. We can choose the meaning we give to it and how we will rewrite our lives to help us live with it."- Sandra Marinella, The Story You Need to Tell: Writing to Heal from Trauma, Illness, or Loss

Why should you hire a Certified Expressive Writing Facilitator when the Pennebaker protocol can be done free and independently, anytime?

I had the same questions until I experienced the writing myself. Once the emotions are brought closer to the surface and seen for what they are in the expressive writing, sometimes they need a new place to go, a new story to be written about the past in order to move into the future with the strengths and tools the experience has given you. But how?

A Certified Expressive Writing Facilitator not only provides accountability and psychological safety, but provides a structured set of intentional prompts and many different types of writing to gain clarity and wisdom to take into the future, so that that significant emotional experience can foster, rather than hinder, sustainable well-being.

What do I do once I've completed the expressive writing protocol and need further healing?The course created by John F. Evans, Transform Your Health: Write to Heal was designed to help reframe, transform, and integrate the past significant emotional experience into something meaningful for the future, as well as access your inner healing voice. You don't need to have writing experience or aspirations in order to participate. The instructor leads you through a progression of restorative writing exercises:

  • Expressive writing, which removes obstacles and moves you beyond a personal, private emotional upheaval or crisis.

  • Transactional writing, which allows you to take care of unfinished business and conveys your feelings, expectations, and intentions for yourself and others, in gratitude, compassion, forgiveness and loving kindness.

  • Poetic writing, which uses narrative structure and metaphor to tell your story as you wish to tell it.

  • Affirmative writing, which centers your focus on your best qualities and how you would like to express your life in the future.

  • Legacy writing, which teaches you to write for others about your values, major life lessons, turning points and epiphanies.

  • Mindful writing, which teaches you to use the principles of mindfulness to address triggers quickly.

What are some of the benefits of the Transform Your Health: Write to Heal course?

  • Creates vision and sets intentions

  • Clarifies values

  • Stimulates thinking that leads to insights and understanding

  • Changes perspective and perception

  • Facilitates mindfulness practice

  • Expresses and defines readiness to change

  • Clarifies importance and builds confidence

  • Removes obstacles to build confidence and resilience

  • Measures progress

  • Encourages staying on track

  • Affirms strengths

  • Communicates and builds gratitude, empathy, and compassion

  • Creates and supports joy and opportunities to flourish

Why should you see for yourself how expressive writing can improve your health?

You know that experience or event you've been thinking about or worrying about way too much? The one you keep trying not to think about? The one that you think you've buried but keeps haunting your days and nights? You can revisit that experience through expressive writing, unearth what has been buried, bring it into the light and examine exactly what happened, give validation and breath to the emotions that resulted from that experience, acknowledge what personal boundaries were violated, what was not ok about what happened, and see for yourself how expressive writing can improve health, transform your lived experiences, and heal yourself.

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