How can expressive writing help to improve mental health and well-being?
This article was written in collaboration with dr. Ralf Cox
The global pandemic has been a great challenge and even when the consequences are visible in most dimensions of daily life, its impacts can be very different for every person. In general terms, this context has required facing uncertainty, being flexible, and incorporating coping mechanisms adjustable to each individual’s reality. This post aims to describe how expressive writing can be a tool to nurture your mental and physical well-being in the context of the pandemic —or other stressful life situations.
The mental health context during the pandemic
It is not new to say that along with the occurrence of COVID-19, most people have experienced some kind of change in their lives, whether in work, social or emotional spheres. In addition, facing an uncertain and stressful situation might contribute to a detriment in well-being and overall health (mental and physical). Psychological science has evidenced for decades the link between very stressful experiences with the subsequent development of physical and mental health complications (Pennebaker & Chung, 2012).
In particular, some of the studies conducted during the pandemic (e.g., Panchal et al., 2021), suggest that the observed mental health disorders are primarily anxiety and major depressive disorder. Another study published in The Lancet from a collaborative study that included three cohorts, suggests that people with chronic disorders perceived a higher impact on their mental health, fear, and diminished coping mechanisms. Furthermore, individuals with depression, anxiety, and obsessive-compulsive disorder might experience a higher detriment in their mental health.
“Some of the studies conducted during the pandemic suggest that the observed mental health disorders are primarily anxiety and major depressive disorder”
Additionally, individuals reactive to changes in their environments (Vaidya & Garfield, 2003), highly anxious (Miller, 2003), avoidant, and self-blaming (Sutker, Davis, Uddo, & Ditta, 1995), might be susceptible to experiencing mental health symptoms after stressful experiences. It is important to mention that individuals who exhibit these symptoms often have a history of depression or post-traumatic stress disorder (PTSD) (Cabrera et al., 2007; Miller, 2003; Pennebaker & Chung, 2012).
The good news is that many people deal with stressful events in a good way without changes in their physical or mental health (Pennebaker & Chung, 2012). However, the evidence can help us understand why paying attention to our mental well-being is so important during stressful contexts. And also, to emphasize the importance of individual differences —such as preexisting mental health conditions— to explain the vulnerability to experience mental health problems. In this context, expressive writing might be a useful tool to improve mental and physical well-being.
What exactly is expressive writing and how is it related to mental health?
Laboratory studies have consistently evidenced both mental and physical health improvements when individuals talk or write about problematic experiences. These health benefits can be subjective or objective markers on overall health and well-being. The core phenomenon related to expressive writing seems to be disclosure, which has a generally positive effect across contexts and problems —whether they are upsetting, stressful, or traumatic experiences. Moreover, the effect is independent of social feedback, which situates the power in the act of disclosing (Pennebaker & Chung, 2012).
“Laboratory studies have consistently evidenced both mental and physical health improvements when individuals talk or write about problematic experiences.”
Expressive writing is the act of writing about an upsetting event in a free and unstructured way (if you are interested in the topic, you can check this article). The purpose is just to let your thoughts and feelings go freely and take shape without caring about grammar, punctuation, or any linguistic formal aspect. The central idea underlying expressive writing is that when individuals convert intrusive thoughts and emotions about upsetting experiences into language, their physical and mental health usually improves (Pennebaker & Chung, 2012). The act of writing can be seen as the processing and integration of upsetting experiences, promoting the emergence of new insights. Consequently, emotional activation and personal meanings related to stressful situations might change in adaptive ways. Accordingly, some studies report a significant reduction particularly in depressive symptoms and rumination (Gortner et al., 2006).
“Expressive writing can be described as the act of writing about an upsetting event in a free and unstructured way.”
For expressive writing to be an effective tool, a person must write about a target experience, situation, or feeling that is causing discomfort. Every person needs to decide how much and for how long to write, depending on the target experience to disclosure. Perhaps somebody who had a very upsetting experience will only require to write about the target event once or twice to experience positive changes; whereas, for someone else, it might take longer. A pioneering study showed that individuals who wrote 15 minutes per day for four consecutive days about an upsetting experience, already exhibited health improvements. These changes were maintained over time when compared with the control group who wrote about superficial topics (Pennebaker & Beal, 1986; Smyth & Pennebaker, 2008).
For expressive writing to be an effective tool, a person must write about a target experience, situation, or feeling that is causing discomfort.
The nature of the event and the impact it has on a person’s well-being plays a role. A further aspect to consider is keeping the writings private, so one feels free to express whatever is needed without any consequence. Possibly, a person will have a broader view of the target situation after the writing than before, or at least the related discomfort might be reduced. Therefore, as a friendly word of advice during these stressful times, if you are experiencing upsetting emotions, thoughts, or experiences, why not give it a try and improve your well-being by simply ‘writing it out loud’.
It is important to mention that expressive writing could be helpful for some people and not for others (like almost everything in this world). For this reason, it is recommended to try, but also, consider this as a tool but never as a treatment itself —or a treatment replacement. If you are experiencing mental health difficulties, it is always advised to seek professional support.
Cabrera, O.A., Hoge, C.W., Bliese, P.D. Castro, C.A., & Messer, S.C. (2007). Childhood adversity and combat as predictors of depression and post-traumatic stress in deployed troops. American Journal of Preventive Medicine, 33, 77–82. https://doi.org/10.1016/j.amepre.2007.03.019
Pan, K., Almar, A,, Eikelenboom, L., Horsfall, M., Jorg, F., Luteijn, R. (2021). The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. The Lancet Psychiatry, 8(2), 121-129. https://doi.org/10.1016/S2215-0366(20)30491-0
Panchal, N., Kamal, R., Cox, C., & Garfield, R. (2021, February 10). The implications of COVID-19 for Mental health and Substance Use. Kaiser Family Foundation (KFF).
Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274–281. https://doi.org/10.1037/0021-843X.95.3.274
Pennebaker, J. & Chung, C. (2012). Expressive Writing: Connections to Physical and Mental Health. H.S. In Friedman (Ed.), The Oxford Handbook of Health Psychology (pp. 1-37). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195342819.013.0018
Miller, M.W. (2003). Personality and the etiology and expression of PTSD: A three-factor model perspective. Clinical Psychology: Science & Practice, 10, 373–393. https://doi.org/10.1093/clipsy.bpg040
Smyth, J.M. & Pennebaker, J.W. (2008). Exploring the boundary conditions of expressive writing: In search of the right recipe. British Journal of Health Psychology, 13, (1-7). https://doi.org/10.1348/135910707×260117
Sutker, P., Davis, J., Uddo, M., & Ditta, S. (1995). War zone stress, personal resources, and PTSD in Persian Gulf war returnees. Journal of Abnormal Psychology, 104, 444–452. https://doi.org/10.1037/0021-843X.104.3.444
Vaidya, N.A., & Garfield, D.A.S. (2003). A comparison of personality characteristics of patients with posttraumatic stress disorder and substance dependence: Preliminary findings. Journal of Nervous & Mental Disease, 191, 616–618. https://doi.org/10.1016/j.ijlp.2009.01.007
Note: Featured image by @sixteenmilesout on Unplash