Evidence For Health & Wellbeing
An online version of this handout, with links to the various mentioned resources, is viewable at: http://goodmedicine.org.uk/stressedtozest/2009/08/writing-health-and-wellbeing
There is lots of research – approaching 200 studies – on the physical and mental benefits of writing about emotional upheavals in our lives. Professor Jamie Pennebaker gives further details of this approach on his website. There are also a couple of handouts about “The power of words” and three about “Therapeutic writing” on the “Life review, traumatic memories & therapeutic writing” page of my website.
I was reminded recently though that it can also be worth exploring other kinds of writing focus. One is the “Best possible selves (BPS)” approach described in Laura King’s 2001 paper (see below). In a study involving writing for 20 minutes on four consecutive days, she found “Writing about life goals was significantly less upsetting than writing about trauma and was associated with a significant increase in subjective well-being. Five months after writing, a significant interaction emerged such that writing about trauma, one’s best possible self, or both were associated with decreased illness compared with controls. Results indicate that writing about self-regulatory topics can be associated with the same health benefits as writing about trauma.”
As is typically the case in writing research, participants randomised to the trauma writing group were given the following kind of instructions: ” … write about some traumatic event or traumatic loss that you have experienced in your life. Write about the experience in as much detail as you can. Really get into it and freely express any and all emotions or thoughts that you have about the experience. As you write do not worry about punctuation or grammar just really let go and write as much as you can about the experience.”
Participants randomised to the “Best possible selves” writing group were instructed: “Think about your life in the future. Imagine that everything has gone as well as it possibly could. You have worked hard and succeeded at accomplishing all of your life goals. Think of this as the realization of all of your life dreams. Now, write about what you imagined.” In a replication study (Sheldon & Lyubomirsky 2006 – see below) the instructions were successfully extended as follows: “You have been … assigned to think about your best possible self now, and during the next few weeks. ‘Think about your best possible self’ means that you imagine yourself in the future, after everything has gone as well as it possibly could. You have worked hard and succeeded at accomplishing all of your life goals. Think of this as the realization of your life dreams, and of your own best potentials. In all of these cases you are identifying the best possible way that things might turn out in your life, in order to help guide your decisions now. You may not have thought about yourself in this way before, but research suggests that doing so can have a strong positive effect on your mood and life satisfaction. So, we’d like to ask you to continue thinking in this way over the next few weeks, following up on the initial writing that you’re about to do.”
It’s fascinating to think about why writing about best possible selves and life goals might be helpful. It may be that writing in this way connects us to “reward approach” systems – see for example the section about “Pleasure and pain” on the excellent Canadian Institute of Neurosciences website “The brain from top to bottom”. The 1998 paper by King & colleagues is also relevant here (see below).
A little more recently, Laura King also looked at possible health benefits from writing about intensely positive experiences (Burton & King, 2004 – see below). Again they found benefits from this further alternative focus. In this case subjects wrote for 20 minutes on three consecutive days following instructions to: “Think of the most wonderful experience or experiences in your life, happiest moments, ecstatic moments, moments of rapture, perhaps from being in love, or from listening to music, or suddenly ‘‘being hit’’ by a book or painting or from some great creative moment. Choose one such experience or moment. Try to imagine yourself at that moment, including all the feelings and emotions associated with the experience. Now write about the experience in as much detail as possible trying to include the feelings, thoughts, and emotions that were present at the time. Please try your best to re-experience the emotions involved. (On the second and third days of writing these instructions included the sentence, ‘’You may either write about the same experience as yesterday, or you may choose a new one.’’).” [Cont.]
In the discussion section of this paper, Burton and King speculate about possible mechanisms of benefit. They write “One way to understand the potential health benefits of writing about IPEs (intensely positive experiences), is to adopt a more general ‘‘life story’’ approach to the benefits of writing. McAdams (e.g., 2001) has proposed that personality might best be understood through the life story. From this perspective, the life narrative comprises the self. Writing about life experience, then, can be understood as engaging in the process of self-construction. Perhaps, by articulating our experiences through writing we integrate these experiences into the self. If we apply this idea to the writing paradigm, we can view writing (about any experience) as a process of articulating and expanding the self. Such a process (regardless of the writing topic) may be expected to relate to enhanced self-regulation, as the writer comes to greater understanding of his or her own needs, priorities, emotions, etc. From this perspective, writing about significant life experiences is a means of obtaining self-understanding, of gaining a more clearly articulated sense of self, and a way of both discovering and creating one’s life goals. As such, the topic of writing need only be important and not necessarily negatively toned, in order to provide health benefits. In keeping with this notion, Eells (2003) recently reported health benefits, particularly for women, after writing about one’s philosophy of life, an unemotional but engaging topic.”
King, L. A. (2001). “The health benefits of writing about life goals.” Pers Soc Psychol Bull 27(7): 798-807.
In a variation on Pennebaker’s writing paradigm, a sample of 81 undergraduates wrote about one of four topics for 20 minutes each day for 4 consecutive days. Participants were randomly assigned to write about their most traumatic life event, their best possible future self, both of these topics, or a nonemotional control topic. Mood was measured before and after writing and health center data for illness were obtained with participant consent. Three weeks later, measures of subjective well-being were obtained. Writing about life goals was significantly less upsetting than writing about trauma and was associated with a significant increase in subjective well-being. Five months after writing, a significant interaction emerged such that writing about trauma, one’s best possible self, or both were associated with decreased illness compared with controls. Results indicate that writing about self-regulatory topics can be associated with the same health benefits as writing about trauma.
Sheldon, K. M. and S. Lyubomirsky (2006). “How to increase and sustain positive emotion: the effects of expressing gratitude and visualizing best possible selves.” Journal of Positive Psychology 1(2): 73-82
A 4-week experimental study (N=67) examined the motivational predictors and positive emotion outcomes of regularly practicing two mental exercises: counting one’s blessings (“gratitude”) and visualizing best possible selves (“BPS”). In a control exercise, participants attended to the details of their day. Undergraduates performed one of the three exercises during Session I and were asked to continue performing it at home until Session II (in 2 weeks) and again until Session III (in a further 2 weeks). Following previous theory and research, the practices of gratitude and BPS were expected to boost immediate positive affect, relative to the control condition. In addition, we hypothesized that continuing effortful performance of these exercises would be necessary to maintain the boosts (Lyubomirsky, S. et al. (2005a). Pursuing happiness: The architecture of sustainable change. Review of General Psychology, 9, 111–131). Finally, initial self-concordant motivation to perform the exercise was expected to predict actual performance and to moderate the effects of performance on increased mood. Results generally supported these hypotheses, and suggested that the BPS exercise may be most beneficial for raising and maintaining positive mood. Implications of the results for understanding the critical factors involved in increasing and sustaining positive affect are discussed.
King, L. A., J. H. Richards, et al. (1998). “Daily goals, life goals, and worst fears: means, ends, and subjective well-being.” Journal of Personality 66: 713-744.
This study addressed the relations among personal strivings (daily goals) and future life goals and worst fears. Eighty undergraduate participants (62 women, 18 men) listed their daily goals, their ultimate life goals, and their worst fears, and completed questionnaire measures of subjective well-being. Daily goals were content-analyzed for relevance to attaining life goals or avoiding worst fears. Daily goals that were instrumental to life goals or that avoided worst fears were rated as more important but also more difficult by participants. Working on daily goals avoiding one’s worst fears was negatively related to measures of subjective well-being, controlling for daily goal progress, difficulty, ambivalence, and importance. Working on daily goals that were instrumental to one’s life goals only weakly predicted well-being. The avoidance of worst fears interacted with daily goal appraisals such that individuals who experienced little progress at daily goals that served to avoid their “worst case scenario” experienced the lowest levels of subjective well-being. In addition, progress at daily goals that were relevant to accomplishing one’s life goals was significantly more strongly related to subjective well-being than progress at daily goals that were unrelated to one’s life goals. Results indicate that daily goals are used to enact life goals and avoid worst fears and that these means-end relations have implications for well-being.
Burton, C. M. and L. A. King (2004). “The health benefits of writing about intensely positive experiences.” Journal of Research in Personality 38(2): 150-163.
In a variation on Pennebaker’s writing paradigm, a sample of 90 undergraduates were randomly assigned to write about either an intensely positive experience (IPE) (n=48) or a control topic (n=42) for 20 min each day for three consecutive days. Mood measures were taken before and after writing. Three months later, measures of health center visits for illness were obtained. Writing about IPEs was associated with enhanced positive mood. Writing about IPEs was also associated with significantly fewer health center visits for illness, compared to controls. Results are interpreted as challenging previously considered mechanisms of the positive benefits of writing.