Enhancing the Benefits of Written Emotional Disclosure Through Response Training

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n = 113) or a neutral writing condition (n = 133). Participants in each condition wrote for 20 minutes on 3 occasions and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure.     

Career writing: Creative,expressive and reflective approaches to narrative identity formation in students in higher education

This study investigates whether creative, expressive, and reflective writing contributes to the formation of a narrative career identity that offers students in higher education a sense of meaning and direction. The contents of writing done by students who participated in 2 two-day writing courses before and after work placements and of a control group were compared. Employers were also asked to evaluate students' performance. Writing samples were analyzed using the Linguistic Index Word Count program and an instrument based on Dialogical Self Theory. Work-placement self-reports were gathered, examined, and used as anecdotal evidence presented in the form of case studies. The results show that career writing can promote the development of career identity and holds promise as a narrative career guidance approach.     

Delving into the ‘emotional storms’: A thematic analysis of psychoanalysts’ initial consultation reports

Psychoanalysts’ written reports on initial consultations are a window into the complexities of a crucial aspect of psychoanalytic work. However, systematic research in this area has largely focused on patients’ demographic factors or standardized measures. The present study looked at reports of all the consultations taking place at the London Clinic of Psychoanalysis over one calendar year (N = 100). The aim was to explore psychoanalysts’ different explicit styles of working and reporting as well as further understanding implicit processes used in thinking and writing about each particular consultation experience. A thematic analysis revealed a set of themes that related to a style of working and thinking about the consultation process as a dyadic experience, where the interaction, affective reactions and contact made between the two are the focus when thinking of making a recommendation for psychoanalysis. The majority of the reports had an open, exploratory quality. The writing of reports appears to give the analyst an opportunity to process the consultation experience and arrive at a more triangular position. Writing reports is a more valuable part of the consultation process than has formally been recognized and acknowledged. The limitations of this study as well as the relevance of these findings for future research are discussed.     

Expressive writing promotes self‐reported physical,social and psychological health among Chinese undergraduates

The present study examines the efficacy of expressive writing among Chinese undergraduates. The sample comprised of 74 undergraduates enrolled in a 9‐week intervention (35 in experimental class vs. 39 in control class). The writing exercises were well‐embedded in an elective course for the two classes. The 46‐item simplified Chinese Self‐Rated Health Measurement Scale, which assesses psychological, physical and social health, was adopted to measure the outcome of this study. Baseline (second week) and post‐test (ninth week) scores were obtained during the classes. After the intervention on the eighth week, the self‐reported psychological, social and physical health of the experimental class improved. Psychological health obtained the maximum degree of improvement, followed by social and physical health. Furthermore, female participants gained more psychological improvement than males. These results demonstrated that the expressive writing approach could improve the physical, social and psychological health of Chinese undergraduates, and the method can be applied in university psychological consulting settings in Mainland China.     

Writing content predicts benefit from written expressive disclosure: Evidence for repeated exposure and self-affirmation

Expressive disclosure regarding a stressful event improves psychological and physical health, yet predictors of these effects are not well established. The current study assessed exposure, narrative structure, affect word use, self-affirmation and discovery of meaning as predictors of anxiety, depressive and physical symptoms following expressive writing. Participants (N = 50) wrote on four occasions about a stressful event and completed self-report measures before writing and three months later. Essays were coded for stressor exposure (level of detail and whether participants remained on topic), narrative structure, self-affirmation and discovery of meaning. Linguistic Inquiry and Word Count software was used to quantify positive and negative affect word use. Controlling for baseline anxiety, more self-affirmation and detail about the event predicted lower anxiety symptoms, and more negative affect words (very high use) and more discovery of meaning predicted higher anxiety symptoms three months after writing. Findings highlight the importance of self-affirmation and exposure as predictors of benefit from expressive writing.     

Structured writing about current stressors: The benefits of developing plans

To investigate the health outcomes of structured writing about everyday stressors, 64 undergraduates selected a stressful event with which they were currently dealing, and wrote about it at home on three occasions in 1 week. Two forms of writing were manipulated: expressive writing?–?exploring one's thoughts and feelings about the stressor; and planful writing?–?developing plans to deal with the problem. Appraisals of control and efficacy were investigated as mediators. Expressive writing yielded no health benefits and did not affect appraisals, but planful writing did. Whereas non-planners' levels of negative affect (NA) remained stable across writing days, planners initially experienced higher NA, but their NA decreased significantly across writing days. Planful writers, relative to non-planners, felt less control over their emotions and less confidence in resolving their problem, but it was non-planners who experienced an increase in stress-related symptoms following writing. Appraisals did not mediate the physical health outcomes.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.