Writing as therapy

Anyone who ever kept a secret diary as a teenager, or indeed in later life, can attest to the cathartic and healing effects of putting distress into words. Research studies have shown that “expressive writing”, as described below, can be of benefit to patients with a wide range of medical and psychiatric conditions.

Most published autobiographies include some account of the more upsetting aspects of their subjects’ lives. The authors of so-called “misery memoirs” carry this to an extreme, taking the adversity they have suffered – for example being abused by parents or partners, suffering illness or injury, or born into a disadvantaged minority group – as their main theme. Some books in this class are authentic and moving, have an educational function and even help to bring about social change. Some are so full of self-pity as to make their readers cringe, and might have been better left unpublished. Some distort the truth for dramatic effect, and a few have been exposed as entirely fraudulent.

Many writers of fiction draw on the more challenging aspects of their own life experience for their plots and themes – whether directly or indirectly, and whether consciously or not. This is certainly true of myself though I hope that readers of my latest novel┬áOverdose – a tragicomedy about the misadventures of a lovesick psychiatrist – will not take it as literally autobiographical.

Besides including fictionalised versions of real events, novelists may use writing as a means of expressing their “shadow side” – perhaps this would explain why so many highly respectable middle-aged women are good at writing murder mysteries.

For the record, here is a brief description of the usual methodology for the expressive writing research. Patients in the study group are asked to write either by hand or on a computer every day for 3 – 5 days, for 15-20 minutes per session, about the most traumatic experience or emotional issue that has affected their lives. This does not have to be directly related to the medical or psychiatric condition they are suffering from. They are advised to write as freely as possible, without regard for spelling or grammar. Patients in the control group are asked to write for the same amount of time, but about some factual objective topic. The material is confidential and need not be shown to the researchers. Some subjects choose to destroy what they have written.

Like any other therapy, this technique does not suit everyone, and responses vary widely. In the main, studies report that those who did the expressive writing, compared to the controls, became more distressed immediately afterwards and that their physical symptoms sometimes temporarily worsened. But in the longer term they reported improved health, mood, and social function. Many of them said that the expressive writing, though upsetting at the time, had been valuable and meaningful.