Writing Therapy

What Is It?
Writing therapy involves putting thoughts and feelings into words as a therapeutic tool. It is based on the belief that recording memories, fears, concerns, and/or problems can help relieve stress, promote health and well-being, and lead to personal growth.

There are a number of different types of writing therapy. One popular form is known as journal therapy. Unlike the kind of diary writing in which a person keeps a log of daily events, journal therapy focuses on expressing emotions, and delving into one’s internal life. In addition to putting a problem or concern into words, journal therapy also can help people work out a solution.

Even though journal writing has been around for centuries, it didn’t become popular as a therapeutic technique until the 1960s, when psychotherapist Ira Progoff founded Dialogue House in New York City. Dialogue House was the first to offer formal workshops and classes in what Progoff called the Intensive Journal method, an extremely structured form of journal therapy (see What You Can Expect, below). In 1985, psychotherapist Kathleen Adams founded the Center for Journal Therapy in Lakewood, Colorado, which today offers certification to journal therapists. These two centers are just two of many in the U.S. and abroad that now offer journal therapy classes and workshops.

Two other popular types of writing therapy are letter therapy, which is often included as part of journal therapy, and poetry therapy, which is taught by therapists who are certified in this area. Letter therapy involves writing very personal letters to people, living or dead. Although these missives are usually never sent, they are intended to express the writer’s most candid thoughts and feelings. Letter therapy offers the writer the opportunity to tell someone the truth without the upset of a face-to-face encounter. In poetry therapy, a person may be asked to create original verse that draws upon their experiences and emotions or to write responses to someone else’s poems as way of expressing their feelings. Often poetry therapy includes reading and creating other forms of literature as well, such as short stories or memoirs.

Many people find writing therapy appealing because after initial sessions with a therapist it is inexpensive (often free), self-initiated, flexible, and portable. It also requires no natural writing talent; what matters is the ability to put one’s innermost thoughts and emotions on paper. Those in writing therapy typically work one-on-one with a writing therapist, who may be a psychologist, psychotherapist, social worker, or other mental health professional credentialed in this technique. There are also writing therapy workshops available through centers such as those mentioned above, as well as guidebooks for home use.

How Does It Work?
By encouraging people to put difficult emotions and memories into words, writing therapy provides therapeutic release. For this reason it has been shown to be particularly beneficial for those who tend to keep their feelings internalized. After a session of writing therapy, many people say they feel calmer and more in control.

In addition, some scientists believe that the release offered by writing affects the body’s physical capacity to withstand stress and to fight off stress-related infection and disease. Writing therapy has also been shown to have a positive impact on heart rate and blood pressure.

What You Can Expect
Your experience in a writing therapy workshop will depend on the type of writing involved as well as the workshop leader, your reasons for being in the workshop, and the other workshop participants. At an Intensive Journal workshop, for example, you will receive a three-ring binder with color-coded sections that correspond to the different aspects of life and the healing process. The workshop leader first explains what the divisions are and then shows you how to start writing in them. The notebook is designed to work as a whole: One section stimulates material for another. Those interested can read their journal entries out loud. After the workshop is over, the process can be continued independently.

Working one-on-one with a writing therapist can have many interesting dimensions as well. Typically, the therapist will begin each session by asking you to write a short “check-in” piece about how you’re feeling, what’s going on in your life, and so on. The therapist may then guide you through a writing a longer piece designed to address the issues brought up in the “check-in” piece. The remainder of the session will probably be spent exploring the information revealed in the longer work, with the writing therapist offering suggestions for writing “homework” to be done before the next session. If you see a psychotherapist who uses writing therapy techniques as a part of an overall treatment process, there will probably be less emphasis placed on the writing assignments.

Writing therapy workshops often take place over a day or two, although they can be longer, and participants may be encouraged to return for further workshops. The number of sessions required for one-on-one therapy depends on how deep-seated a person’s issues are.

Health Benefits
Writing therapy has been used effectively to help people with a number of physical and emotional problems, including a life-threatening illness such as cancer; chronic conditions such as asthma and rheumatoid arthritis; drug and alcohol addictions; eating disorders; and trauma. It has also been shown to be beneficial for combating low self-esteem, depression, and stress-related ailments.

In addition, writing therapy has been employed to help people cope with grief and loss. For example, poetry therapists were asked to work with the students of Columbine High School in Littleton, Colorado, after the shooting tragedy there in 1999.

Studies have also shown that when people write about emotionally difficult events for just 20 minutes a day for three or four days, the function of their immune system improves. In a 1998 study published in the journal Health Psychology, college freshmen who wrote about their feelings and problems and created coping strategies, were found to make fewer visits to the medical clinic than those who didn’t write.

In another study, published in 1999 in the Journal of the American Medical Association, a striking connection between writing therapy and relief from chronic illness was shown. Researchers found that asthma patients who wrote about difficult experiences such as divorce, physical abuse, and car accidents improved their lung function by an average of 19%. Rheumatoid arthritis patients who wrote about these subjects improved by an average of 28%. In contrast, a control group of patients who wrote about innocuous subjects showed no improvement at all. It is important to note that the writing therapy was not used as a substitute for standard medical care, but as a complement to it.

How To Choose a Practitioner
Most writing therapists first obtain an advanced degree in psychology, counseling, social work, or a related field. They then enter a credentialing program, such as that offered by the National Association for Poetry Therapy in Washington, D.C. They can also study with and receive certification from an organization such as the Center for Journal Therapy or Dialogue House (see What Is It?, above). These organizations also certify writing therapy workshop leaders, who come from a variety of professional backgrounds.

For a referral or workshop information, contact any of the organizations note above. Your primary-care physician may also be able to refer you to a writing therapist or a psychotherapist who uses writing therapy techniques.

Writing therapy should not be used as a substitute for standard medical care, especially if you suffer from asthma, rheumatoid arthritis, or another serious medical condition. The therapy can bring up emotions that are very difficult to handle. If you decide to pursue at-home writing therapy and it becomes too difficult, cease the solo effort and consult a trained professional for help. Writing therapy is not recommended for people who have been diagnosed as psychotic.

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