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Writing Cures

Exploring the Effects of Emotionally Expressive Writing in both Clinical and Non-Clinical Populations


Writing cures; or at least it has beneficial effects in some populations; numerous papers have discussed the benefits and potential limitations to expressive emotional writing, and the potential use of such a technique in a clinical population. From Seligman’s 3 good things, to gratitude letters, to Pennebaker’s Writing Paradigm- there are various takes on writing as a form of therapy, but they all stress the emotional expression element (a selection of various techniques are discussed in this page). Another important issue in writing therapy are the mechanisms by which the practise operates- for a multitude of types of therapy there are a multitude of proposed mechanisms and theories by which this therapy benefits its subjects.

Perhaps the most contentious point of all in writing therapy is the debate over which aspects of said therapy can be exploited for use in a clinical setting. It has been overwhelmingly proven by various means that emotionally expressive writing is beneficial in a variety of ways to the healthy individual. It has also been shown that expressive writing is beneficial to those suffering from physical illnesses. What has not been shown without doubt, are the various ways writing therapy can be of benefit to a given clinical population. Another issue is the speculation that rumination can be potentially detrimental to the clinical population. These issues are discussed at length in the clinical applications section.

Also discussed are the historical roots of writing as a therapy, and the cultural heritage of such a technique. The position of writing therapy in positive psychology is subject to a critique of it's claims and empirically findings, and several papers are suggested for further reference of various issues within the field.

1) History
2) Old Cultural Connection
3) Practical exercises an individual could carry out
4) Clinical Applications
5) Mechanisms
6) Critique
7)A note on writing cures and arts therapies
8)Three Key Papers
9) References


Before Pennebaker

Writing as a form of therapy could be said to have existed for many years before Pennebaker’s expressive writing study was first published in 1986. The practise of keeping a journal has existed for centuries; a self-disclosure exercise not dissimilar to those proposed by psychologists such as Pennebaker and Seligman. Famous examples include the diary of Anne-Frank, written during a families hiding from religious persecution. It would not be outrageous to speculate that this diary was a therapeutic means by which Anne coped with the prevalent anxiety and distress that constant fear of discovery would undoubtedly inspire.

Further historical examples can be found in Ancient Greece; the idea of catharsis (defined as cleansing or purging), in an emotional sense referring to the purging of ill feeling by the appreciation of an aesthetic experience. This idea has been particularly linked to the work of Aristotle (see cultural connections).

The use of writing in therapy as such seems to have originated in psychodynamic theory; Freud and Breuer are often cited as having suggested the use of writing therapy in their book of case studies, “Studies on Hysteria” (1895), in which they postulate that the inhibition of emotional and traumatic memory expression leads ultimately to physical and mental distress, indeed the inhibition of emotional information has been shown to be detrimental to both mental and physical health (eg. Scheff, 1979). More recently, the ‘Intensive Journal Method’ was pioneered in the early 70’s by Ira Progoff, a student of Carl Jung’s. This technique was based on the assertion that self-disclosure is both beneficial and necessary, but uses a structured form of journal in order to avoid the apparent problem in the unstructured journal which “usually just goes around in circles.” (Progoff, 1975). The Journal contains sections such as ‘Dialog with Persons’ and ‘Dialog with Inner Wisdom’. This form of expressive writing is extremely structured in comparison to various other techniques, with Intensive Journal Writing meetings and workshops held during the course of the program. The method is well known, but there are few statistically empirical reviews of its efficacy.

After Pennebaker

Pennebaker is probably best known for his work on expressive writing and its beneficial effects on mental and physical health; one of his first studies (Pennebaker & Beall, 1986) made the idea of writing about traumatic events somewhat of a talking point in the field of therapy. This study contrasted the physical and mental health benefits of writing expressively about an emotional or traumatic issue with writing about something trivial; something without any emotional association. Results showed that the emotional writing group made significantly less visits to healthcare institutions during the months after the experiment. Understandably then, a claim that writing for a period of half an hour per day for a period of less than a week could generate such immediate physical health benefits was greeted with much interest.

Numerous studies followed this, using variations of the paradigm and subject group, and measuring various mental and physical affects (eg.Esterling et al, 1994 Greenberg & Stone, 1992). A meta-analysis of written emotional expression and the health benefits of this practise was published in 1998 by J.M Smyth. The analysis examined the effects of writing about trauma, e.g. writing about ongoing trauma (Pennebaker, Colder, & Sharp, 1990) or writing about the most traumatic events in the subject’s life (Greenberg & Stone, 1992). The analysis found various effect sizes- the overall affect size for improvement being 0.47, or 23%. This effect size is a mean of the effect sizes for all the various measured benefits, including psychological well-being, reported health (visits to health professionals, self-report), general functioning (grade point average, reemployment) and physiological well-being (heart rate, blood pressure, cholesterol, skin conductance, etc). The scope of both mental and physical health benefits supposedly related to expressive writing can be seen simply in the variety of studies analysed here. Written expression was found to have a larger effect size in students, and also in males, the reasons for which are unclear and likely to be numerous (Smyth, 1998).

Furthermore, the health effects from expressive writing are similar, and in some cases better, “than those produced by other psychological, behavioural, or educational treatments” (Smyth, 1998). Pennebaker and others speculated as to the mechanisms underlying the benefits of writing about traumatic experiences, hypothesising that the improvements might be as a result of expressing the traumatic emotions and consequently ‘facilitating the cognitive processing of these memories’ (Pennebaker, 1989). It has also been suggested that negative events are more strongly associated with analytical processing and insight, and so ‘working through’ these events is particularly beneficial (Clore, 2002) (see mechanisms).

However, speculation as to why expressive writing about traumatic experience may be beneficial became less significant with subsequent publications, when it was shown by several studies showing that writing about intensely positive experiences has similarly beneficial effects on the individual (Burton & King, 2004, King & Miner, 2000). Specifically, Burton and King’s (2004) paper replicated Pennebaker’s 1986 study, with similar results in terms of reduced visits to health care practitioners in the experimental group, and a surprising increase in visits amongst the control group. Importantly, it has been demonstrated that writing about superficial or trivial subjects does not provide the same health benefits (Pennebaker, 1986, Burton & King, 2004), so the benefit would appear to lie somewhere in the expression of emotional material.

Several meta-analyses and a huge number of studies (see reference section) have demonstrated the beneficial effects of expressive writing; from effects on psychological well-being, to physical health; improved immunity (Esterling et al, 1994); claims of better recovery from asthma and rheumatoid arthritis (Smyth et al, 1999); even improvement in symptoms of HIV (Petrie et al, 2004). Most recently, expressive writing has been shown as being beneficial in the treatment of Irritable Bowel Syndrome (Halpert et al, 2010).Studies have also demonstrated improvement in general functions; grade point averages, reemployment statistics (Pennebaker, Mayne & Francis, 1997), and many more. The beneficial effects discussed in these papers largely relate to benefits in ‘healthy’ subjects, the picture is not so clear in clinical subjects. Some studies seem to have found several significant results (Frisina et al, 2004), particularly in PTSD (Smyth et al, 2008) while other studies have highlighted the dangers of rumination; especially in a clinical population (rumination has been shown to have an insignificant effect in non-dysphoric subjects (Lyubomirsky, 1995)).

Emotionally expressive writing is now a readily available self-help therapy, with instructions freely and widely available online, and in many self-help books. Its application as yet remains incomplete, in terms of the various environments in which it could be used. The mechanisms behind the benefits are also unclear, although the benefits (in the healthy population at least) are definitely significant.

Old Cultural Connection

Ancient Greece

The idea that benefits can arise from emotional expression and self disclosure is not a new phenomenon. In fact, ancient Greek philosophers were some of the first to recognise the power that emotional expression could have on psychological well-being and they highly valued poetry for its expressive and healing nature. Aristotle in particular, used the term 'Katharsis', meaning 'cleansing' or 'purging', to describe the way in which writing and performing poetry could help people get rid of inner torment and negative emotions. Aristotle originally used this term as a medical expression, describing how faeces, menstrual blood and reproductive matter are expelled from the body, but he later used the word metaphorically to explain the way in which emotions could be released from the body too. Aristotle saw emotional expression through poetry as a way to control one's emotions in a healthy way, rather than allowing emotions to be bottled up inside and have control over you. Many years later, Freud adopted the term and used it in his psychoanalytic theory to explain the process in which people let go of negative emotion through talking about their thoughts and feelings.

Practical exercises an individual could carry out

Pennebaker - 'Writing to heal'

In Pennebaker's book 'Writing to Heal: A guided journal for recovery from trauma and emotional upheaval' (2004), he gives the reader a writing assignment, in which he asks them to have a think about the emotions that have influenced their life the most over the years and write about these emotions. In writing about their deepest thoughts and feelings, Pennebaker claims that the reader will be able to explore their emotions and get a greater understanding of how they have shaped their life.

Pennebaker's basic writing assignment

“Over the next four days, write about your deepest emotions and thoughts about the emotional upheaval that has been influencing your life the most. In your writing, really let go and explore the event and how it has affected you. You might tie this experience to your childhood, your relationship with your parents, people you have loved or love now, or even your career. Write continuously for 20 minutes”

He also includes some advice on writing to heal too:

  • Find a time and place where you won't be disturbed.

  • Write continuously for at least 20 minutes.

  • Don't worry about spelling or grammar.

  • Write only for yourself.

  • Write about something extremely personal and important for you.

  • Deal only with events or situations you can handle now.

Pennebaker claims that writing expressively in this way can have a positive impact on people's physical and emotional health. He suggests that when words are used to convey our emotions, it helps us to understand ourselves and our emotions much better. He sees expressive writing as a way of releasing negativity and has found that in the individuals he has tested, there were large reductions in anxiety and rumination when they wrote about their thoughts and feelings. Emotional well-being was generally boosted in these individuals too.

'Three Good Things' – Seligman's gratitude journal exercise

Seligman claims that people tend to spend more time thinking about what has gone wrong in their lives, rather than the things that have gone well. He states that focusing on the good even that have happened increases happiness and decreases depression. He devised the Three Good Things exercise (also known as the 'Three Blessings exercise') to get people to think about the more positive aspects of their lives and challenge negative thought patterns.

The 'Three Good Things' exercise involves writing down 3 things that you are grateful for or were happy about that day before going to bed each night and spend some time reflecting on why they occured. Seligman claims that in doing this every night it will help the individual appreciate the day to day positive aspects of their life and encourage optimism about the future. This will in turn boost positivity and mood, and lead to health benefits, according to Seligman.

Below is the link to a video, in which Martin Seligman briefly talks about the Three Good Things exercise and how it has been designed to increase positive thinking.

Writing a gratitude letter - Lyubomirsky

Like Seligman, Lubomirsky also believed that expressing gratitude and appreciation through writing could have a large positive impact on mood and emotional well-being (Lyubomirsky et al, 2009). She claims that gratitude can play a big role in boosting self-esteem, strengthening social relationships and most importantly, helping people to focus on the positive opposed to the negative areas of their lives.

One of the ways that she suggests that you can practice being grateful by writing a gratitude letter to someone who you feel has had a really positive influence on your life, detailing how you appreciate what they have done for you over the years, how they made you feel and what impact they have had on your life. After writing the letter, the next step is to give them the letter in person and discuss together what you have written in your letter. Lyubomirsky states that even just the act of writing the letter alone and not sending it has been shown to boost happiness, but sharing those emotions with the person you are thanking can be a very powerful and uplifting exercise. Toepfer and Walker (2009) explored the impact that expressive writing through gratitude letters could have on well-being and found that this activity increase gratitude and happiness in their participants, just as Lyubomirsky had found in her research. However, she points out that expressing gratitude in this way is most effective when done on a weekly basis rather than a daily basis, as to keep the feelings of gratitude fresh and varied.

Clinical Applications

Recently, many studies have attempted to evaluate the effects of expressive writing on clinical populations. Although results are still tenuous, with mixed findings, expressive writing has been found to result in improvements in physical, social, psychological, behavioural functioning in a wide-variety of populations (Pennebaker & Chung, in press). The basic writing paradigm, involving the disclosure of a traumatic experience, has been used in many studies to investigate the effects of writing on individuals who suffer from Post Traumatic Stress Disorder (PTSD) and other trauma related disorders, such as depression.

Frisina et al (2004) carried out a meta-analysis on the effects of written emotional disclosure on health outcomes in clinical populations. They concluded that expressive writing significantly improved health, but effects were more robust for physical health issues like asthma, arthritis, than for psychological health where all domains were unaffected. These results are supported by Sloan and Marx (2004) who found that expressive writing didn’t lead to a decrease in PTSD-related symptom severity, but did decrease physiological activation during trauma-related writing.

When comparing these results with those of Smyth’s (1998) meta-analysis in healthy populations it appears that there is more effect in healthy populations than in clinical. Supporting this comparison are the results of Harris’s (2006) meta-analysis which compared the number of health care visits before and after writing about stressful events, in both healthy and clinical populations. He found that even though expressive writing reduces health care utilization in healthy samples, it doesn’t in Clinical.

In comparison with the aforementioned findings, Baikie and Wilhelm (2005) meta-analysis found that writing about traumatic events shows significant improvements in physical AND psychological health in BOTH clinical and healthy population. Students with trauma history, for example, showed improvements in physical health, PTSD symptomatology and other aspects of psychological well-being. The authors did, however, acknowledge that not all studies found benefits and list groups for which only limited benefits were found like male psychiatric prison inmates, victims of natural disasters or children of alcoholics amongst others. Baikie and Wilhelm (2005) also interestingly found that expressive writing was detrimental for adult survivors of childhood abuse and worsened their PTSD-related symptoms.

While findings are mixed for the effects of expressive writing on psychological health, studies on the effects on physical health have been consistently positive. Expressive writing has been found to enhance immune functioning (including immune response in HIV), lower reduce pain and physical health in cancer patients and helped to reduce the severity of a variety of other diseases (Baikie and Wilhelm, 2005; Smyth, 1999; Halpert et al., 2010).

Like expressive writing all forms of psychotherapy, including psychoanalysis, behavioural and cognitive therapies, aim at reducing distress and promoting mental and physical well-being (Pennebaker, 1997). Many of these therapies have adopted writing as an adjunct. Cognitive Behavioural Therapist have been interested in expressive writing for some time due to findings that it has the same efficacy as Cognitive Behavioural Therapy (CBT) when treating acute stress disorder and PTSD (Pennebacker, 2004; Van Emmerick et al., 2008). One study that combined CBT and writing - Cognitive Behavioural Writing Therapy (CBWT) - found this to be an effective intervention for the treatment of child traumatic experiences (Van De Oord et al., 2010). Thus expressive writing is widely applied in a variety of therapies, despite inconsistent findings and occasional negative results mentioned above.

This may be due to writing being an inexpensive, easy, independent and relatively universal way for people to resist the mental and physical ravages of stress and disease.


Whilst there is a large body of evidence showing various positive psychological and health effects from using the writing paradigm, the mechanisms causing these changes are not so obvious, and many possible mechanisms have been suggested. One of the earliest suggestions was that writing combated the ill effects associated with social and individual inhibition such as those demonstrated in studies such as Pennebaker & Beall (1986) and Pennebaker (1989). Inhibition theory reasoned that inhibiting thoughts and feelings was associated with low level physiological work in a similar manner to stress. Furthermore it was suggested that people were more likely to inhibit thoughts relating to more socially threatening material such as sexual trauma. It was thought then that writing about these inhibited thoughts and feelings may have been responsible for the positive changes, however evidence has been mixed. Several early studies attempted to test this mechanism and found that writing about secret traumas did not predict greater health improvements than writing about public traumas e.g., Greenberg & Stone, 1992). More recently some progress has been made (e.g., Lepore, Fernandez-Berrocal, Ragan, & Ramos, 2004; Lepore, Ragan & Jones, 2000), where people are encouraged to talk about an emotional experience, react less if what they say is validated by another person.

Another possibility is the role of emotional expression. The very first writing study found that whilst a group writing about emotional content evidenced positive change, a group writing about the facts of an event showed no change. Consistent with an experiential approach to psychotherapeutic change, emotional acknowledgement ultimately fosters important cognitive changes (Ullrich & Lutgendorf, 2002). Pennebacker notes that whilst emotional expression is important experiments such as Krantz & Pennebaker, 2007 have shown that health gains require emotions to be expressed AND translated into language.

A variation on emotional expression is the concept that through expressing thoughts and feelings through writing, the author becomes habituated to the feelings instilled by the trauma they are tackling. This theory has been tested in experiments such as Sloan, Marx, and Epstein’s 2005 study which looked at the difference between subjects repeatedly writing about the same incident and subjects writing about different topics, finding that the repeating group experienced the greatest improvement in post traumatic stress symptoms. However other studies such as Campbell & Pennebaker, 2002 have found that the more similar subjects essays were the less likely they were to experience health improvements. This indicates that a pure habituation argument is probably insufficient in explaining the expressive writing effects. The findings previously mentioned Pennebaker and Beall (1986) together with those reported by Krantz and Pennebaker (2007) that mere activation of emotions can provide only limited benefits. Beyond habituation processes, some form of cognitive change is also important.

Another possibility is that the words used by subjects could shed light on a mechanism; perhaps expression of one particular emotion is more beneficial than others, or some similar effect? To examine the use of words in writing, computer programs have been employed to count the quantity of words associated with certain emotions (happy, laugh, angry, sad etc.). Using the LIWC program to re-analyse previously gathered date finding that the more people used positive emotion words, the more their health improved whilst negative emotion word use, was curvilinearly related to health change after writing. Individuals who used a moderate number of negative emotions in their writing showed the greatest drops in physician visits in the period after writing (Pennebaker, Mayne, & Francis, 1997). Further work in this area has shown that individuals who use very few negative emotion words, or use a very high amount of them are those likely to suffer no positive health effects from writing. It has been suggested that individuals who tend to use few negative emotion words are most likely to be characterized as repressive copers (cf., Schwartz & Kline, 1995) whilst, on the other hand, those who overuse negative emotion words may well be the classic high Negative Affect individuals described by Watson and Clark (1984).

A key part of insight‐oriented therapies is that through psychotherapy clients are able to develop a better understanding of their problems and reactions to them (e.g., Rogers, 1980). Integral in this understanding is the ability to stand back and look at oneself from different perspectives. Whilst the majority of therapists would agree with the importance of changing perspectives, this poses problems to researchers seeking to chart this change. One approach has been to use the same word detection software noted previously, this time, however, the goal is to detect function words to gauge how the person is writing. One study found that the more people change in their use of function words from day to day, the more their health improved (Campbell & Pennebaker, 2003). Further analysis revealed that the effects were entirely due to changes in pronoun use, specifically, the more that people changed between their use of first person pronouns (I, me, my) and all other personal pronouns (e.g., we, you, she, they), the more greater their health improvements. Such findings have been interpreted as reflecting a change in perspective from one writing day to the next. Once again more recent research has taken some of the shine from this idea, with studies suggesting that requiring people to switch perspectives does not confer benefits beyond standard writing instructions. These findings suggest that changes in perspective are more an emergent property of successful writing, reflecting psychological improvement rather than necessarily causing it.

For further detail on mechanisms refer to Pennebaker and Chung (key paper - listed below).


Gap between announced theory and empirical evidence

Most studies comparing writing alone, to talking either into a tape recorder or to a therapist in a one-way interaction find comparable biological, mood and cognitive effects (Pennebaker & Chung, in press). Talking and writing about emotional experiences are both superior to writing about superficial topics. However, when individuals discuss problems with friends in a two-way interaction, different results are found.

Co-rumination is the excessive discussion of personal problems within a dyadic relationship and is characterized by frequently discussing problems, discussing the same problem repeatedly, mutual encouragement of discussing problems, speculating about problems and focusing on negative feelings. Friendship research shows that self-disclosure leads to close relationships, while coping research shows dwelling on negative topics (rumination) leads to emotional difficulties. Co-rumination integrates both these areas of research (Rose, 2002).

Writing interventions have people write about traumatic experiences, which could be considered as rumination and hence found to be maladaptive by coping research and leads to emotional difficulties. This, however, isn’t the case and writing about traumatic events has led to significant physical and mental health improvements. These results contrast those of coping research which state that those who cope best don’t dwell on traumatic experiences (Rose, 2002).

Interestingly, girls report greater co-rumination than boys, particularly among adolescents. Lower levels of co-rumination among boys are thought to help buffer boys from emotional problems if they spend less time with friends dwelling on problems and concerns (it helps them cope - Rose, 2002). Contrastingly, males seem to benefit more than females from expressive writing (Smyth, 1998).

Overall, both types of self-disclosure are thought to be important as co-rumination leads to close friendships and writing leads to health benefits. Differences between the two theories may arise from cognitive processes alone indicating ruminative processes, whereas cognitive processes and a corresponding discovery of meaning may indicate a successful reconciliation of traumatic events (Creswell et al., 2010). Thus talking to others about problems may use many cognitive processes, but there is no discovery of meaning, as seen when writing about traumatic events.

Another critique about the area is... that no single mechanism has been found to explain writing’s positive effects. Writing is thought to work, but it is not known how. Until research discovers the mechanisms behind the effects, data can only be correlational. Therefore, we cannot know if it is the writing that is producing the effects or another experimental factor. Although in light of this being a new field, correlational data is a good place to start.

A note on writing cures and arts therapies

The attentive reader may have noticed that some aspects of Pennebaker’s writing paradigm seem to be similar to the area of arts therapies (such as dance, drawing etc), indeed some of the mechanisms suggested are feasible for both areas. For instance we have noted the efficacy of the writing paradigm being partly explained by emotional expression, this same mechanism could also be applied to art therapies, say expressive dance therapy, where a client employs art (in this example dance) as a means to expressing emotions instead of writing. Additionally we see the same focus on the process of producing in both writing cures and art therapy; it is not the quality of the final product, be it an essay, poem, dance, drawing or piece of music but the value of creating it that is focussed on. Whilst there is obvious similarities there also exists major differences, whilst both areas utilise self-disclosure, writing tends to be a solitary activity, and the piece of writing may well never be read by anyone beyond the author. In art therapy however the therapeutic process relies not only on producing the work, but on the interaction between the therapist and the patient, though as noted above the therapist won’t be providing artistic critique, they are there to help interpret the product and the emotions behind it by providing a supportive environment. Group interactions are also quite common in art therapies where group members are encouraged to share their work with each other.

Above we have talked about art therapy in forms such as dance or drawing, however writing and literature is also a form of art, and we can find some writing cure models where there is even more similarity with art therapy. Sophie Nicholls, a practitioner of a “developmental creative writing” model, uses the following question with here clients:

“Experiment with using writing techniques that help you to shift into a more felt, bodily awareness. This might involve doing 10 minutes of free-writing every morning, or taking that last phrase you’ve written and repeating it over and over down the page. Try taking a few lines of someone else’s poem and using it as a starting point for your own free-writing. Play with full rhymes and half-rhymes. Say the words out loud, focusing on their sound and rhythm rather than their meaning.”
(Nicholls, 2009)

In this question you can see a greater focus on the style of writing as well as content. Indeed, the question asks the author to consider rhyme, sound and rhythm over meaning and to consider incorporating a line or two of poetry, which adds a distinctly artistic slant to this writing cure (though, as noted above most art therapies wouldn’t advocate this). Later in the paper the author notes that something deemed to be lacking from Pennebaker’s Writing Paradigm is group interaction, or interaction with a writing facilitator/therapist, which is very much a trait of arts therapies.

Three Key Papers:

Pennebaker, J.W. & Chung, CK. (in press) Expressive writing and its link to mental and Physical health. In H.S. Friedman (Eds), Oxford Handbook of Health Psychology, New York, NY: Oxford University Press

If you only read one paper on writing cures, this should be it. The paper gives a good overall summary of Pennebaker's basic writing paradigm - discussing it's origins, uses, effects on subclinical and clinical populations and also outlines the possible mechanisms behind these effects (see previous sections of wiki).

Smyth, J. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66(1), 174-184

This paper reviews the relationship between a written emotional expression task and subsequent health. Writing was found to significantly increase health outcomes in healthy participants. Health improvements were found in 4 outcome types reported - physical health, psychological well-being, physiological functioning and general functioning, but health behaviour was not affected.

Frisina, G.P., Borod, J.C. & Lepore, S.J. (2004). A Meta-Analysis of the Effects of Written Emotional Disclosure on the Health Outocmes of Clinical Populations. The Journal of Nervous and Mental Disease 192, 9, 629-635

The title says it all. This Meta-analysis summarizes the effects of writing on clinical populations. They found that expressive writing significantly improved health outcomes. However, the effect was stronger for physical that for psychological health outcomes. Writing was less effective for psychiatric than physical illness populations. The authors compared their findings to those of Smyth's (1998) meta-analysis of effects in healthy populations. Healthy populations benefit more from the basic writing paradigm than clinical poplations.


Baikie, K.A., Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment 11, 338-346

Burton, C.M., King, L.A. (2004). The healthy benefits of writing about intensely positive experiences. Journal of Research in Personality 38, 150-163

Campbell, R.S., & Pennebaker, J.W. (2003). The secret life of pronouns: Flexibility in writing style and physical health. Psychological Science, 14, 60-65

Clore, G. L., & Tamir, M. (2002). Affect as embodied information. Psychological Inquiry, 13, 37–45

Creswell, J.D., Lam, S., Stanton, A.L., Taylor, S.E., Bower, J.E. (2007). Does Self-Affirmation, Cognitive Processing, or Discovery of Meaning Explain Cancer Related Health Benefits of Expressive Writing? Society for Personality and Social Psychology 33, 2, 238-250

Esterling, B., Antoni, M., Fletcher, M., Marguiles, S., & Schneiderman,N. (1994). Emotional disclosure through writing or speaking modulates Epstein-Barr virus antibody titers. Journal of Consulting and Clinical Psychology, 10, 334-350.

Freud, S., & Breuer, J. (1960). Studies on hysteria (J. Strachey, Trans.)New York: Avon Books. (Original work published 1895)

Frisina, G.P., Borod, J.C. & Lepore, S.J. (2004). A Meta-Analysis of the Effects of Written Emotional Disclosure on the Health Outocmes of Clinical Populations. The Journal of Nervous and Mental Disease 192, 9, 629-635

Glarden Brand, A. (1979) The Uses of Writing in Psychotherapy. Journal of Humanistic Psychology, Vol. 19, No. 4, 1979

Greenberg, M. A., & Stone, A. A. (1992). Emotional disclosure about traumas and its relation to health: Effects of previous disclosure and trauma severity. Journal of Personality and Social Psychology, 63, 75-84

Halpert, A., Rybin, D. & Doros, G. (2009). Expressive Writing Is a Promising Therapeutic Modality for the Management of IBS: A Pilot Study. The American Journal of Gastroenterology.

Harris, A.H.S. (2006). Does Expressive Writing Reduce health Care Utilization? A meta- Analysis of Randomized Trials. Journal of Consulting and Clinical Psychology 74, 2, 243-252

King, L.A. & Miner, K.N. (2000). Writing About the Perceived Benefits of Traumatic Events: Implications for Physical Health. Personality and Social Psychology, 26/2, 220-230

Krantz, A.M. & Pennebaker, J.W. (2007). Expressive dance, writing, trauma, and health: When words have a body. In I.A. Serlin, J Sonke‐Henderson, R. Brandman, and J. Graham‐Pole (Eds), Whole person healthcare Vol 3: The Arts and Health (pp 201‐ 229). Westport, CT: Praeger.

Lepore, S. J., Fernanadez‐Berrocal, P., Ragan, J., & Ramos, N. (2004). It's not that bad: Social challenges to emotional disclosure enhance adjustment to stress. Anxiety, Stress & Coping: An International Journal, 17, 341‐361.

Lepore, S. J., Ragan, J., & Jones, S. (2000). Talking facilitates cognitive‐emotional processes of adaptation to an acute stressor. Journal of Personality & Social Psychology, 78, 499‐508.

Lyubomirsky, S. (2009) How and why do positive activities work to boost well-being? An experimental longitudinal investigation of regularly practicing optimism and gratitude. Manuscript under review.

Lyubormirsky, S., & Nolen-Hoeksema, S. (1995). Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology, 69, 176-190

Mazza, N. (2003) Poetry therapy: theory and practice. Brunner Routledge

Nicholls, S. (2009) Beyond Expressive Writing: Evolving Models of Developmental Creative Writing. Journal of Health Psychology, 14, 171-180.

Pennebaker, J. (1989). Confession, inhibition, and disease. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 22, pp. 211-244). New York: Academic Press

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.

Pennebaker, J. W., & Chung, C. K. (in press). Expressive writing and its links to mental and physical health. In H. S. Friedman (Ed.), Oxford handbook of health psychology. New York, NY: Oxford University Press.

Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528 -537

Pennebaker, J.W. (1997). Writing About Emotional Experiences as a therapeutic process. Psychological Science 8, 7, 161-166

Pennebaker, J. W., Mayne, T., & Francis, M. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72, 863-871.

Pennebaker, J. W. (2004). Writing to heal: A guided journal for recovering from trauma & emotional upheaval. Oakland, CA: New Harbinger Press.

Pennebaker, J.W. & Chung, CK. (in press) Expressive writing and its link to mental and Physical health. In H.S. Friedman (Eds), Oxford Handbook of Health Psychology, New York, NY: Oxford University Press

Petrie KJ, Fontanilla I, Thomas MG, Booth RJ, Pennebaker JW(2004): Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: A randomized trial.Psychosomatic Medicine,66:272–275.

Progoff, I. (1975). At a journal workshop: The basic text and guide for using the intensive journal process. New York: Dialogue House Library

Rose, A.J (2002). Co-Rumination in the Friendships of Girls and Boys. Child Development 73, 1830-1843

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