Writing therapy
Encyclopedia
Writing therapy is a form of expressive therapy
that uses the act of writing and processing the written word as therapy. Writing therapy posits that writing one's feelings gradually eases pain and strengthens the immune system. Writing therapeutically can take place individually or in a group and it can be administered in person with a therapist or remotely through mailing or the Internet.
The field of writing therapy includes many practitioners in a variety of settings. The therapy is usually administered by a therapist or counsellor. Several interventions exist on-line, writing group leaders work in hospitals with patients dealing with their mental and physical illnesses and in university departments aiding student self-awareness and self-development. When administered at a distance it is useful for those who prefer to remain personally anonymous and are not ready to disclose their most private thoughts and anxieties in a face to face situation.
As with most forms of therapy, writing therapy is adapted and used to work with a wide range of psychoneurotic illnesses including bereavement, desertion and abuse. Many of these interventions take the form of classes where clients write on specific themes chosen by their therapist or counsellor. Assignments may include writing unsent letters to selected individuals, alive or dead, followed by imagined replies from the recipient or parts of the patient's body, or a dialogue with the recovering alcoholic's bottle of alcohol.
, a psychology professor who became deeply interested in the physical and mental benefits of self disclosure.
In Pennebaker's original experiments, one group of his students was directed to write for 20 minutes on three consecutive days on the worst traumas of their lives, while an equal number was asked to write of trivial matters.
Firstly, the amount of undisclosed trauma in the life of the average American student was surprisingly high. And secondly, there was a marked difference between these two groups of students. In those who had written of trivial matters there was no change either in their physical or mental health, whereas those who had done these brief trauma-recall exercises showed a marked strengthening of their immune system, decreased visits to the doctor and significant increases in psychological well-being. These findings were measured using physiological markers (long term serum measures, antibody levels, cell activity, enzyme levels, muscular activity, etc.), behavioural markers and self-report (distress, depression, etc.).
Pennebaker's experiments, begun over twenty years ago, have been widely replicated and validated.
Following on from Pennebaker's original work, there has been a renewed interest in the therapeutic value of abreaction
. This was first discussed by Josef Breuer
and Freud in Studies on Hysteria
but not much explored since.
An additional line of enquiry that has particular bearing on the difference between talking and writing derives from Robert Ornstein
's studies into the bicameral structure of the brain. L'Abate postulates that:
This requires the services of a counsellor or therapist, albeit sitting at a computer. Given the huge disjunction between the amount of mental illness compared with the paucity of skilled resources, new ways have been sought to provide therapy other than drugs. In the more advanced societies pressure for cost-effective treatments, supported by evidence-based results, has come from both insurance companies and government agencies. Hence the decline in long term intensive psychoanalysis
and the rise of much briefer forms, such as cognitive therapy
.
Ironically, the anonymity and invisibility provides a therapeutic environment that comes much closer than classical analysis to Freud's ideal of the "analytic blank screen". Sitting behind the patient on the couch still leaves room for a multitude of clues to the analyst"s individuality; e-therapy provides almost none. Whether distance and reciprocal anonymity reduces or increases the level of transference
has yet to be investigated.
Expressive therapy
Expressive therapy, also known as expressive arts therapy or creative arts therapy, is the use of the creative arts as a form of therapy. Unlike traditional art expression, the process of creation is emphasized rather than the final product...
that uses the act of writing and processing the written word as therapy. Writing therapy posits that writing one's feelings gradually eases pain and strengthens the immune system. Writing therapeutically can take place individually or in a group and it can be administered in person with a therapist or remotely through mailing or the Internet.
The field of writing therapy includes many practitioners in a variety of settings. The therapy is usually administered by a therapist or counsellor. Several interventions exist on-line, writing group leaders work in hospitals with patients dealing with their mental and physical illnesses and in university departments aiding student self-awareness and self-development. When administered at a distance it is useful for those who prefer to remain personally anonymous and are not ready to disclose their most private thoughts and anxieties in a face to face situation.
As with most forms of therapy, writing therapy is adapted and used to work with a wide range of psychoneurotic illnesses including bereavement, desertion and abuse. Many of these interventions take the form of classes where clients write on specific themes chosen by their therapist or counsellor. Assignments may include writing unsent letters to selected individuals, alive or dead, followed by imagined replies from the recipient or parts of the patient's body, or a dialogue with the recovering alcoholic's bottle of alcohol.
Research into the therapeutic action of writing
By far the greater part of the research into writing therapy has been conducted in the US, especially in recent years. The earliest and most important work was directed by James W. PennebakerJames W. Pennebaker
James W. Pennebaker is an American social psychologist. He is the Centennial Liberal Arts Professor and Chair of the Department of Psychology at the University of Texas at Austin and a member of the Academy of Distinguished Teachers...
, a psychology professor who became deeply interested in the physical and mental benefits of self disclosure.
In Pennebaker's original experiments, one group of his students was directed to write for 20 minutes on three consecutive days on the worst traumas of their lives, while an equal number was asked to write of trivial matters.
Firstly, the amount of undisclosed trauma in the life of the average American student was surprisingly high. And secondly, there was a marked difference between these two groups of students. In those who had written of trivial matters there was no change either in their physical or mental health, whereas those who had done these brief trauma-recall exercises showed a marked strengthening of their immune system, decreased visits to the doctor and significant increases in psychological well-being. These findings were measured using physiological markers (long term serum measures, antibody levels, cell activity, enzyme levels, muscular activity, etc.), behavioural markers and self-report (distress, depression, etc.).
Pennebaker's experiments, begun over twenty years ago, have been widely replicated and validated.
Following on from Pennebaker's original work, there has been a renewed interest in the therapeutic value of abreaction
Abreaction
Abreaction is a psychoanalytical term for reliving an experience in order to purge it of its emotional excesses; a type of catharsis. Sometimes it is a method of becoming conscious of repressed traumatic events....
. This was first discussed by Josef Breuer
Josef Breuer
Josef Breuer was an Austrian physician whose works laid the foundation of psychoanalysis.Born in Vienna, his father, Leopold Breuer, taught religion in Vienna's Jewish community. Breuer's mother died when he was quite young, and he was raised by his maternal grandmother and educated by his father...
and Freud in Studies on Hysteria
Studies on Hysteria
Studies on Hysteria was a book published in 1895 by Sigmund Freud and Josef Breuer. It contained a number of Breuer and Freud's case studies of "hysterics". It included one of their most famous cases, Breuer's Anna O. , which introduced the technique of psychoanalysis as a form of cure...
but not much explored since.
An additional line of enquiry that has particular bearing on the difference between talking and writing derives from Robert Ornstein
Robert Ornstein
Dr. Robert Evan Ornstein is a psychologist, researcher and writer.He has taught at the Langley Porter Neuropsychiatric Institute, based at the University of California Medical Center in San Francisco, and been professor at Stanford University and chairman of the Institute for the Study of Human...
's studies into the bicameral structure of the brain. L'Abate postulates that:
One could argue, for instance, that talk and writing differ in relative cerebral dominance. ... if language is more related to the right hemisphere, then writing may be more related to the left hemisphere. If this is the case, then writing might use or even stimulate parts of the brain that are not stimulated by talking. (L'Abate: 2004)
The role of the distance therapies
With the accessibility provided by the Internet the reach of the writing therapies has grown beyond all recognition. It has become possible for a client and therapist anywhere in the world to work together, provided they can write the same language. They simply "enter" into a private "chat room" and engage in an ongoing text dialogue in "real time".This requires the services of a counsellor or therapist, albeit sitting at a computer. Given the huge disjunction between the amount of mental illness compared with the paucity of skilled resources, new ways have been sought to provide therapy other than drugs. In the more advanced societies pressure for cost-effective treatments, supported by evidence-based results, has come from both insurance companies and government agencies. Hence the decline in long term intensive psychoanalysis
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...
and the rise of much briefer forms, such as cognitive therapy
Cognitive therapy
Cognitive behavioral therapy is a psychotherapeutic approach: a talking therapy. CBT aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure in the present...
.
Writing therapy via the Internet
Currently the most widely used mode of Internet writing therapy is via e-mail (see analytic psychotherapist Nathan Field's paper The Therapeutic Action of Writing in Self-Disclosure and Self-Expression). It is asynchronous; i.e. messages are passed between therapist and client within an agreed time frame, say one week, but at any time within that week. Where both parties remain anonymous the client benefits from the "disinhibition" effect; that is to say, feels freer to disclose memories, thoughts and feelings that they might withhold in a face-to-face situation. Both client and therapist have time for reflecting on the past and recapturing forgotten memories, time for privately processing their reactions and giving thought to their own responses. With e-therapy, space is eliminated and time expanded. Overall it considerably reduces the amount of therapeutic input, as well as the speed and pressure that therapists habitually have to work under.Ironically, the anonymity and invisibility provides a therapeutic environment that comes much closer than classical analysis to Freud's ideal of the "analytic blank screen". Sitting behind the patient on the couch still leaves room for a multitude of clues to the analyst"s individuality; e-therapy provides almost none. Whether distance and reciprocal anonymity reduces or increases the level of transference
Transference
Transference is a phenomenon in psychoanalysis characterized by unconscious redirection of feelings from one person to another. One definition of transference is "the inappropriate repetition in the present of a relationship that was important in a person's childhood." Another definition is "the...
has yet to be investigated.