The Natural Connection

I know people who would rather saw their toes off than write a sentence. A complete paragraph can throw them into a serious anaphylactic fit. They will sing to you, play charades, kiss pigs in public—but they will not write. 

I remember the sheer terror I felt as a junior in high school, when I discovered that my chosen elective, Woodshop, was not offered to girls. The principal told my father that the boys in the class sometimes used foul language, and it was certainly not the place for nice young Sicilian women. So I was forced to take a writing class, the only unfilled class available, and broke out in hives. I might have even sawed off my toes, if they had let me into Woodshop. I was that afraid to write. 

Incredibly, my high school writing teacher had more faith in me than I had in myself. She gently eased us into understanding that we would not suffer a fatal upset stomach or a terminal acne attack if we learned to express ourselves with written words. Probably recognizing that I would likely never write a Great American Novel, she later encouraged me to go to medical school, and for that I am thankful as well. 

Therefore, it was with a particular sense of gratitude that I recently attended a keynote presentation given by Dr. James Pennebaker of the University of Texas at Austin at the conference The Psychology of Health, Immunity, and Disease. Dr. Pennebaker is the author of the best seller, Opening Up: The Healing Power of Expressing Emotion (Guilford Press, 1997). He and his Texas colleagues are experts in the emerging field of teaching patients with chronic illness to use writing or journaling to decrease pain and improve function without any “medication” other than an ink pen. 

The study techniques that they use are simple. A person is asked to write for 20 minutes on three consecutive days about the most stressful event of their lives. They are asked to write continuously, without worrying about spelling or grammar. They are asked to write as if they will destroy what they have written when they are done. The health status of these individuals is then compared to those who are asked to write about non-emotional issues, like fruit salad or painting a chair. 

The results of this simple writing exercise are profound. Multiple studies over the past decade now clearly demonstrate that putting emotional experiences into written words can have significant positive effects on both physical and mental health. Patients with chronic disease such as asthma and arthritis, in particular, seem to benefit the most, but this technique has been studied in a wide variety of patient types. 

The patients in the writing studies who wrote about stressful events in their lives have fewer doctor visits, and take fewer medications for illness, compared to controls. Their blood pressures are lower, and markers of their immune function indicate that their immune systems are healthier. They lose less time from work, and have greater optimism in the face of job stress, such as lay offs. One study of unemployed “downsized” executives who were entered into a writing therapy program showed that they found new employment quicker and at a higher pay than those who did not write, or who wrote about non-emotional topics. Anxious college students have been shown to improve their ability to focus, concentrate, and improve their grades. 

One extremely intriguing study was reported in JAMA in August 1999 by. JM Smyth, et al. Their team from the Department of Psychiatry at State University of New York found that groups of patients with asthma showed significant improvements in lung function up to four months after completing a three-day writing exercise, compared to control subjects with identical illness. Similarly, patients with moderate rheumatoid arthritis reported decreases in their joint pains and their doctors noted decreases in the disease severity months after the study was complete. 

Right now, no one knows how or why writing about emotional issues for brief periods seems to help heal chronic illness and pain. We also don’t know if writing on a computer will produce the same results, as all the studies have been done with pen and paper. There may be something about the scribbling and scratching out and reworking on paper that is necessary to promote healing—something that may be lost somehow in our new age of spellcheckers and CONTROL+ALT+DELETE. There are others who believe that computer typing may stimulate more areas of the brain than handwriting, and could possibly be even more beneficial. 

One thing is perfectly clear to me. I wouldn’t be surprised if you live to see the day where your doctor asks you to “Write me three stories, and call me in a week. We’ll talk.” But I still don’t know where I would have ended up in life if the principal had let me take Woodshop. 

To receive more information on this topic, please write to: The Natural Connection, c/o Dr. Pauline Bellecci, PO Box 777, Waycross, GA 31502 

©2000-2003 Pauline M. Bellecci, MD