Writing It Out - Integrating Thoughts and Feelings

Pennebaker (1986) conducted a study about journaling.  He randomly assigned subjects (college students) to one of the following groups and asked them to write about...

(1) ... a superficial or trivial topic - for example, a description of their living room or the shoes they were wearing.  (Control Group)

(2) ... their feelings associated with one or more traumas in their life (Trauma-Emotion Group)

(3) ... the facts surrounding traumatic events (Trauma-Fact Group)

(4) ... both their feelings and the facts surrounding the traumas (Trauma-Combination Group)

(all groups wrote for 15 minutes per night on four consecutive nights)

Before and after writing each essay, he measured their...

• blood pressure
• heart rate
• self-reported moods
• self-reported physical symptoms

Four months after the end of the study, subjects completed questionnaires about their health and general views of the experiment.

Before and six months after the study, the health and counseling center records of study participants were collected.

This is what he found:

• At first, the Trauma-Combination Group writers had a large increase in blood pressure from before to after the essay.  After the first writing session, they showed moderate decreases in blood pressure from before to after the session.
• Those that wrote about trauma reported more negative moods after writing the essays, whereas Control Group writers felt more positive.
• There was an overall increase in health center visits for illness in all conditions except the Trauma-Combination group.
• A trend suggesting that those in the Control Group reported the most days their activities had been restricted due to illness and the Trauma-Combination Group the least.
• Overall, participants in the Trauma-Combination and Trauma-Emotion Groups reported reductions in health problems relative to those in the Control and Trauma-Fact Groups.
• Those in the Trauma-Emotion and Trauma-Combination Groups were more likely to have thought about their essays than those in the Trauma-Facts or Control Groups.

"Although I have not talked with anyone about what I wrote, I was finally able to deal with it, work through the pain instead of trying to block it out.  Now it doesn't hurt to think about it." -- Trauma-Combination writer

In his discussion, Pennebaker notes:
"Theorists argue that the resolution of a trauma is associated with the cognitive work of organizing, assimilating, or finding meaning to the events surrounding the trauma."

"...tying both the cognitions (thoughts) and affect (feelings) surrounding traumatic events was optimally effective in maintaining long-term health."

"Jourard (1971) argues that self-disclosure allows for one's feelings and thoughts to become more concrete, which ultimately results in greater self-knowledge.  Disease results, according to Jourard, when the motive toward self-understanding is blocked."

"We have argued that the act of inhibiting behavior is physiologically stressful.  Previous surveys indicate that not confiding in others about a traumatic event - which we view as a form of behavioral inhibition - is associated with disease."  (We avoid to take a break from the pain of talking about or thinking about the memory, but avoidance takes its toll)

"Although writing about traumas appears to have positive long-term health effects, we must pinpoint the aspect of this exercise that is beneficial.  Possibilities include making an event concrete, linking the affective and cognitive aspects, the reduction of forces associated with behavioral inhibition over time, and so forth."

Reference:
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.