I've already written a series of five blog posts about the British Association for Behavioural & Cognitive Psychotherapies (BABCP) conference in Manchester last month.  One of the plenary presentations I went to was given by Jamie Pennebaker who spoke about "Expressive writing in clinical practice".  The entry on page 28 of the "Conference abstracts" book was pretty brief, just saying: "Writing about emotional upheavals in controlled experiments tends to improve physical and emotional health.  How do the research findings generalize to real world clinical practice?  Drawing on recent studies on writing and natural language use, a number of recommendations will be suggested concerning who should write, when the writing should be done, how the writing samples should be treated, and ways to think about writing as homework or direct boost to therapeutic sessions".

I like Jamie Pennebaker.  I like the body of research on expressive writing that he's done stretching back 25 years.  I like his style too.  I've heard him lecture two or three times and chatted with him.  Quite laid back, not dogmatic or prescriptive.  I've written quite extensively on this website about therapeutic writing.  See, for example, the three posts from this January on "Writing (& speaking) for resilience & wellbeing", last year's post "Writing for health & wellbeing", and the post from earlier this week on teaching therapeutic writing for the "Life skills" evening class that I run.  Clicking "writing" in the tag cloud will pull out a fuller listing of relevant material on this site.  I wondered if it was worth my while going to this talk, because I'm already familiar with this research area.  I'm glad I did.  I was struck particulary by - 1.) Some new developments & comments about Pennebaker's expressive writing work.  2.)  Disagreement with Jamie Pennebaker's implication that therapeutic writing is best kept for past traumas and that writing generally isn't likely to be helpful when focusing on positive experiences (and some thoughts about trusting "data" before "heroes"!).  

So firstly 1.) Some new developments & comments about Pennebaker's expressive writing work.  Here are a series of jottings I made as Jamie was lecturing.  There are now about 250 research articles on expressive writing.  Overall effect sizes are modest but consistent at about 0.2.  A point I have heard Jamie make in a previous lecture is that the typical effect size achieved in research on expresssive writing has decreased over the years.  For example, Joshua Smyth in his important 1998 paper "Written emotional expression: effect sizes, outcome types, and moderating variables" reported a considerably bigger average effect size of 0.47 which he commented "suggest that the effect of the writing task is similar to that found in other quantitative analyses of psychological interventions".  Why might effect sizes in more recent studies on expressive writing be less than those found in earlier studies?  Possible causes might be initial researcher allegiance effects or improved later research methodology or - and I've heard Jamie musing about this - maybe self-disclosure is more a part of normal U.S. cultural behaviour than it was in the 1990's so that the comparison control groups are now getting a bit of "expressive writing/expressive talking" themselves.  To use an antibiotic parallel, maybe current expressive writing research is not so much a comparison between penicillin or no penicillin as a comparison between a moderate dose of penicillin and a smaller dose of penicillin.  

This leaves me wondering if some cultures - and types of people - might benefit more from expressive writing than others.  Jamie has produced evidence showing that northerners may be less emotionally open than southerners, so maybe I should particulary be pushing the value of expressive writing here in Scotland!  He also, in this Manchester talk, mentioned two research studies - involving military personnel and college students - trying to help couples with adjustment difficulties.  In both cases apparently benefits were obtained when the male of the couple did the expressive writing but not vice-versa.  Difficult.  Other studies have shown no gender difference in how much people benefit from this kind of intervention.  Maybe culture & gender (& even age) are just hints about whether someone might be vulnerable to an over-repressive style.  There is good work showing that emotional suppression comes at a cost and that expressive writing, for example, can be of particular value for people who ruminate a lot and for those scoring high on suppression as indicated by responses to the "Emotion Regulation Questionnaire".  You can click through, as well, to a handout giving scoring & background details about this questionnaire and variation in typical suppression scores by gender & age.  See previous blog posts too on work from "Oregon university" and "Stanford psychophysiology lab" with their focus on this fascinating emotion regulation area.     

See tomorrow's post for more on Jamie Pennebaker's talk .