Self-expressive writing is often used in therapeutic settings where people are asked to write about their thoughts and feelings related to a stressful event.
Bottling up emotions can lead to stress and sometimes depression and as such, writing can increase mental health because it offers a safe and confidential way to express emotions instead of bottling them up.
This article discusses the many benefits of self-expressive writing to clients and how they can overcome their fears and get started on writing.
Before you continue, we thought you might like to download our three Goal Achievement Exercises for free. These detailed, science-based exercises will help you or your clients create actionable goals and master techniques to create lasting behavior change.
This Article Contains:
- Benefits of Writing
- Instructions for the Practitioner
- Working with Writing Therapy
- A Collection of Self-Expressive Writing Worksheets
- Further Writing Resources
- A Take-Home Message
- References
Benefits of Writing
The positive effects of self-expressive writing are:
- A significant healing effect in individuals who have experienced a traumatic or extremely stressful event. Participants in a study who wrote about their most traumatic experiences for 15 minutes, four days in a row, experienced better health outcomes up to four months later (Baikie & Wilhelm, 2005).
- Over 100 asthma and rheumatoid arthritis patients showed similar results as above. Participants who wrote about the most stressful event of their lives experienced better health evaluations related to their illness (Smyth, Stone, Hurewitz, & Kaell, 1999).
- A recent study suggested that expressive writing may even improve immune system functioning, although it may need to be sustained for the health benefits to continue (Murray, 2002).
- In a study by Burton and King (2004), mood measures were taken before and after participants wrote about either an intensely positive experience (IPE) or a neutral topic for 20 minutes each day for three consecutive days. The results showed that writing about IPEs was associated with an enhanced positive mood along with significantly fewer health center visits for illness, compared to controls.
In addition to these more concrete benefits, regular therapeutic writing can help the writer:
- Find meaning in their experiences, view things from a new perspective, and see the silver linings in their most stressful or negative experiences (Murray, 2002).
- Experience important insights about themselves and their environment that may be difficult to determine without focused writing (Tartakovsky, 2015).
Writing therapy has proven effective for many different conditions or mental illnesses, including (Lepore & Smyth, 2002; Pennebaker, 1997, 2004):
- Posttraumatic stress
- Anxiety
- Depression
- Obsessive-compulsive disorder
- Grief and loss
- Chronic illness issues
- Substance abuse
- Eating disorders
- Interpersonal relationship issues
- Communication skill issues
- Low self-esteem
- Increased feelings of wellbeing
- Reduced physician visits
- Reduced absenteeism from work
- Improved academic grades
- Enhanced immune system functions
Instructions for the Practitioner
It was in the early 1980s that professor James Pennebaker stumbled upon a finding that prompted him to explore further.
People who reported having a highly traumatic experience and who kept the experience a secret showed far more health problems than people who openly talked about their trauma.
His research also showed that, compared to people who were told to write about non-emotional topics, those who wrote about trauma showed improved physical health.
“[…] emotional writing boosted immune function, brought about drops in blood pressure, and reduced feelings of depression and elevated daily moods.”
(The Secret Life of Pronouns, 2011)
Your help as a practitioner can be hugely beneficial to your client. When reading or listening to your client’s writing, try to discover in what way the client is expressing their emotions. Are there any signs of emotions being talked over too quickly or being suppressed? Is there repetition in their choice of vocabulary?
If clients are using a high number of what is referred to as ‘negative emotion words’ in their writing, this is not only a sign that something is wrong but also a sign that it may be time for you as a therapist to intervene.
Pennebaker found that the more people used positive emotions while writing about emotional upheavals, the more their physical and mental health improved in weeks and months after the experiment.
Pennebaker’s research also concluded that people whose health improved the most from writing used only a moderate number of negative emotion words.
“People who expressed negative emotion language at very high rates did not benefit from writing – almost as if they were awash in their unhappiness.”
(The Secret Life of Pronouns, 2011)
This means as a helping professional, it is your job to make sure that a client uses a healthy mix of positive and negative emotional words to express themselves.
You can do this by asking your client to describe:
- The situation from both a positive and negative point of view.
- Both the positive and negative emotions they experienced.
- What good things a certain negative experience led to later in life.
Note that it’s not about stimulating your client to be overly positive or negative in a forced way. Rather, it’s about helping your client to use a healthy mix of positive and negative emotional words when expressing themselves, correcting the imbalance between the two.
To summarise, when discussing your client’s writing with them, try to discover:
- The reason why they are sharing these particular emotional experiences.
- What kind of adjustment the client is showing in their writing.
- Whether they are using a healthy balance between positive and negative emotional words to express themselves.
Start with your confidentiality agreement
You can start by telling your client that – as with the rest of the therapy – nothing they share in writing will be read by anyone without their consent, including you.
Let your client decide whether they want you to:
- Read all of their writing.
- Read only what they feel comfortable sharing with you.
- Don’t read any of their writing.
- You can also ask your client to read aloud what they feel like sharing. This way you can gauge their response, hear their tone, and see their emotions.
Explain the goal of these writing exercises
Make it clear what the goal of the writing exercise is before the client starts. This should prevent frustration and strengthen the client’s resolve to follow through.
The client should not be concerned with anything else except writing a certain amount of words for a certain amount of time. We have found this approach works best with writing exercises.
Instruct your client not to be concerned about:
- Spelling or grammar
- Word use (all curse words allowed)
- Consistency
- Sticking to a topic
- Whether their writing is “any good”
- Anyone else but you reading their writing
- Succeeding or failing
- Writing too much
Know that your client often carries not just their problems within them, but also the solutions. Writing is a way to extract both the problems and the solutions. As a helping professional, you facilitate and guide them through this process.
It is why it’s recommended that you, the practitioner, have done these writing exercises yourself before giving them to a client. Insight is key!
Working with Writing Therapy
Advice from practitioners working with writing therapy:
I’ve been a big believer in writing as a superhighway to the subconscious since I began my practice many years ago. For many people, it can be a great outlet and effective tool. I have found adding a component of ritual is particularly useful as well.
For example, journaling about letting go of trauma or pain is supercharged by adding the ritual of burning the pages when the writer feels like he or she is ready. As the brain registers the literal release of the pain, all the senses become involved and the message of moving past the issue is absorbed fully into consciousness.
– Marilynn Halas
Usually, when I work with writing I like to start the session in a relaxed manner (guided meditation). We will then discuss a subject that I propose and immediately following the clients are given 10-15 minutes to write freely.
Afterwards, the clients in the group who would like to share, read out what they have written within the circle. For the last step, I like to get everybody to share in one word, what they are taking home from the writing session.
– Tiziana De Giosa
A lot of client struggle is with letting go of their addict-life and getting in touch with who they are and where it is they want to go to. For clients, it is useful to have small exercises, (autonomic) goal-oriented, to make the transition from their self-destructive addicted life towards a value-based life.
At this moment, writing is not regularly implemented in therapy sessions. Sometimes I ask clients, to briefly evaluate the day in the evening by writing three things for which they are grateful. I have to note that the intellectual and introspective capacities among clients often differ very much.
-Berber Jacquemijns
I notice that not all of my clients are comfortable expressing their feelings. Some do, some shy away, whilst others just can’t. Of course, in all cases, I use writing therapy little or more depending on the responses I get from them.
I use it as a catharsis tool. I literally call it the ‘vomit’ time!
I ask my clients to write on a topic, which we then read together in order to gain perspectives on the emotions that they have transferred to paper. These are in the form of questions. The brain becomes aware of why a particular, paragraph, sentence or word has been written as it has just been transferred from the subconscious mind. When we read it together, there is a deeper level of understanding to that feeling/emotion.
Stay with the client even if the writing does not make any sense at a conscious level but as a practitioner, we can recognise that the writing comes from a place of hurt, pain, grief and/or happiness and joy. Emotions can cloud writing and it takes time to separate the water from the mud.
This form of therapy helps make the client an expert of their own experience. From a trauma-informed approach, it gives the client/writer the ability to literally re-write their trauma narrative which could be considered the integration phase of trauma recovery.
Also, it allows clients to identify, look up words and use examples which they may not have the confidence to communicate through speech. Research is just starting to catch up now on the healing powers of writing. Writing therapy allows room for story-telling which many cultures engage in and use to pass on their history and traditions. I would imagine from Eastern philosophy this is what one would refer to as “speaking their truth”..
– Anu Krishna
Most of the time, a topic of what to write about will come up during a session. From there they may be asked to do a writing assignment based on what is said.
For example, a client that has 30+ years of sobriety almost killed himself at the age of 21 while driving under the influence. During one of the sessions, he lamented that he wished someone had talked to him about his behavior because he may be in a better place at this point in this life. The accident caused significant spinal injuries so he has some physical deficits associated with gross motor movements.
His assignment was to write a letter to his 21-year-old self to let him know how his life was turning out. My goal was to help him see how much he had accomplished in his life, what he was currently doing, and how the accident contributed in some positive ways as well.
We discussed the assignment and since it was developed during the session, I had not had the opportunity to think about clear examples to answer the client’s questions. We spent a few sessions after he wrote the letter to flesh out some additional information and he was able to gain closure.
When I request writing assignments, clients invariably ask how to do it. I typically ask them questions to help them think about what’s important to them. Sometimes it’s still unclear for them, so I will verbally start a letter with them and ask them to fill in the blank.
– Diane Shepard
A Collection of Self-Expressive Writing Worksheets
Here are other helpful self-reflective writing worksheets to further help your client.
Motivation for the Client
This worksheet contains basic instructions on writing to help your client get started.
It will help the client understand why they are writing and learn something about themself and gain insight into the thought process behind choices and decision-making.
Fear Setting
The fear setting worksheet will help clients identify their fears and actions to overcome said fears.
It’s a structured checklist to identify clients’ fears and highlight the benefits and rewards of taking the action needed or the results of inaction.
Healing from Trauma Through Writing
Since writing is a form of expressive therapy, the goal of this exercise is to help clients find meaning and resolution in their trauma.
This exercise is intended to focus on your most traumatic life experience. Let your ideas flow fluidly as you recount the past, the present, or the future. As you write, explore the emotions.
Reflection Prompts
Reflection prompts are a great tool to make daily journaling easy and fun. They are simple, quick questions to be asked regularly.
They can also overcome the paralysis and mind blankness that can happen when faced with staring at nothing but a blank page.
Self-Reflective Writing Exercises
This worksheet contains a list of self-reflective writing exercises. It is beneficial to spend more time reflecting on and working through the topics in these exercises.
Working Towards Your Ideal Self
The Working Towards Your Ideal Self worksheet will encourage your client to place themselves in their ideal future — a life of their own making.
It will allow the client to visualize what the best version of themselves would look like and establish a framework of goals whilst highlighting harmful or non-conducive behavior.
Writing About Intensely Positive Experiences
Writing About Intensely Positive Experiences for 20 minutes over three consecutive days will help improve the client’s mood.
Further Writing Resources
“The truth knocks on the door and you say: “Go away, I’m looking for the truth,” and so it goes away. Puzzling.”
― Robert M. Pirsig, Zen and the Art of Motorcycle Maintenance
1. Catching the Big Fish: Meditation, Consciousness, Creativity – David Lynch
Ideas are like fish. If you want to catch little fish, you can stay in the shallow water.
But if you want to catch the big fish, you’ve got to go deeper.
Available on Amazon.
2. Naikan: Gratitude, Grace, and the Japanese Art of Self-Reflection – Gregg Krech
This collection of introductory essays, parables, and inspirations explains what Naikan is and how it can be applied to life.
Available on Amazon.
3. Expressive Writing: Words that Heal – James Pennebaker and John Evans
Revealing research results, this book shows the effect expressive writing has on physical health.
The book reveals why writing therapy, as opposed to talking therapy, can be more effective, especially when dealing with trauma.
From the instructions: “Write about what keeps you awake at night. The emotional upheaval bothering you the most and keeping you awake at night is a good place to start writing.”
Available on Amazon.
A Take-Home Message
In summary, there are great therapeutic benefits to writing and writing therapy. Keeping a journal can be extremely helpful for the user.
It is a low-cost, easily accessible, and versatile form of therapy. It can be done individually or guided by a mental health professional. It can be practiced within a group and even added as a supplement to another form of therapy.
These benefits are certainly not trivial, as the potential positive outcomes of self-expressive writing therapy reach much further and deeper than simply writing in a diary.
We hope you enjoyed reading this article. Don’t forget to download our three Goal Achievement Exercises for free.
Credits to Craig Smith for helping me put all this together.
References
- Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in psychiatric treatment, 11(5), 338-346.
- Burton, C. M., & King, L. A. (2004). The health benefits of writing about intensely positive experiences. Journal of research in personality, 38(2), 150-163.
- Lepore, S. J., & Smyth, J. M. (2002). The writing cure: How expressive writing promotes health and emotional well-being. American Psychological Association.
- Murray, M. (2002). Beyond the myths and magic of mentoring: How to facilitate an effective mentoring process. John Wiley & Sons.
- Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological science, 8(3), 162-166.
- Pennebaker, J. W. (2004). Theories, therapies, and taxpayers: On the complexities of the expressive writing paradigm.
- Pennebaker, J. W. (2011). The secret life of pronouns. New Scientist, 211(2828), 42-45.
- Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Jama, 281(14), 1304-1309.
- Tartakovsky, R. (2015). The case for pace. Style, 49(1), 65-77.
