I've already written a couple of appreciative posts about Jamie Pennebaker's fascinating talk at the BABCP Manchester conference - one on "Expressive writing & emotional suppression" and another on "Expressive writing & timing issues".  I'm now going to write a couple of posts disagreeing with points Jamie appeared to make in his talk - one on the limited time focus he seemed to suggest expressive writing is relevant for, and the other on his remark that it isn't helpful writing about positive experiences.  I say "Jamie appeared to make" because I don't actually believe he's unaware of these issues.  Unfortunately, I do believe many people attending this talk may well have gone away misunderstanding these two points - and they're important points. 

I very much respect Jamie Pennebaker's work and have done for many years.  He's a bit of a "hero" of mine.  However hearing him make the remarks he did about writing, time & emotional tone - and the remarks' possible effects on a large number of British psychotherapists - left me thinking about a much more severe example of "the expert" sometimes being believed ahead of the data.  Robert Koch was a great physician, awarded the Nobel Prize for identifying and describing Mycobacterium tuberculosis.  Sadly he didn't believe that bovine (cattle) and human tuberculosis were similar, which delayed the recognition of infected milk as a source of infection (condemning many people to preventable disease and death).  The message - good science can be viewed as the intelligent application of doubt; follow the data not the expert. 

So here's a diagram I've developed further from the one illustrated in my post on Emily Holmes's talk on imagery.  It's also downloadable as a PDF or Powerpoint slide.

The two "bones I want to pick" with Jamie's talk are the limited time focus that he suggested expressive writing is helpful for, and the limited emotional tone (just negative) he suggested writing in general is potentially helpful for.  I think some people will have left this talk thinking therapeutic writing is only relevant to the bottom left corner of the diagram (above) and not even the whole of this time section as Jamie had commented that the time to consider expressive writing is possibly weeks rather than days after an upsetting event.  I would argue strongly that research shows that expressive writing is applicable across the whole breadth - past, present & future - of negative, distressing experiences (although possibly it's best to avoid expressive writing in the first days after significant trauma).  In tomorrow's post I'll further argue that therapeutic writing is actually applicable across all six areas of the above diagram, and that good research shows benefit with focusing on past, present & future issues of both negative & positive emotional tone.  By therapeutic writing I mean all forms of writing that are being used for therapeutic benefit (to decrease distress and/or to increase wellbeing).  Therapeutic writing includes Jamie Pennebaker's expressive writing but also includes writing based on other underlying theoretical orientations such as affirmation theory, attachment theory, dissonance theory, aspects of positive psychology, and so on.    

In this post I want to highlight that research shows that Jamie Pennebaker's style of expressive writing is in fact applicable across the whole breadth of negative, distressing experiences - past, present and future.  As far back as 1998, Smyth - in his review "Written emotional expression: effect sizes, outcome types, and moderating variables" - noted "Whether participants were instructed to write about past, current, or past and current traumas was not related to the overall effect size".  Since then there have been a series of studies where participants have benefited from writing about a situation that they are still in at the time.  This research has involved cancer sufferers, people undergoing surgery, women with chronic pelvic pain, gay men facing prejudice, sufferers from organizational injustice, job loss and other groups.  Sometimes the expressive writing instructions have been slanted towards the "traumas" that initiated participants' current state, however in other research studies the instructions have clearly been broader and encouraged writing about all emotionally important aspects of their current difficulties.  In fact Jamie alluded to this in his talk, when he said "We now sometimes just ask people to write about something of personal emotional importance to them and find that it's about as helpful as asking them to write about their worst traumas".   

So research shows that expressive writing is relevant for both past "traumas" and also current distress.  As an aside I would comment that so-called posttraumatic symptoms seem to be common after many difficult life events, not just those we would typically classify as "traumatic" - see Mol et al's paper "Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study" for more on this.  Now there are also studies emerging showing the potential benefits of expressive writing for imagined difficulties in the future that haven't even happened yet!  So Dalton & Glenwick published a paper last year entitled "Effects of expressive writing on standardized graduate entrance exam performance and physical health functioning" and reported "A substantial body of literature has demonstrated that expressive writing about an individual's deepest thoughts and feelings regarding a past or ongoing stressful experience results in a wide range of beneficial effects, including physical health and cognitive functioning. The authors examined the effects of writing about a future stressful experience--an impending graduate entrance exam--by comparing the exam performance and physical health functioning of participants who wrote about their deepest thoughts regarding the exam with those of participants who wrote about neutral and nonemotional topics. The experimental group reported a mean exam score that was significantly (19 percentile points) higher than that of the comparison group (i.e., the control group). The participants in the experimental group who wrote on 3--compared with fewer--occasions experienced the greatest benefits. The authors propose possible causal mechanisms for the results and suggest future research questions and applications".

Great!  So the bone I've just picked was that I believe some people may have left Jamie Pennebaker's Manchester talk thinking that expressive writing was just relevant for past traumas (and even then only after a gap of some weeks).  Although I think there are genuine issues about not writing expressively too soon after traumatic experiences, it's clear that research highlights the potential value of expressive writing across the whole spectrum of past, present and even future difficulties.  A great tool to know about and to use for ourselves and - if we're therapists - for our clients as well.

In tomorrow's post I'll argue that therapeutic writing (although not so much expressive writing) is also potentially beneficial when the focus is on positive experiences as well.