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Health
Systems
Healing
Through the Written Word
By
Karen
Cangialosi, MFA, MA
Writing
is not only a salve but often a tool that opens our minds and hearts
to things that are deep inside us. The famous American poet, EE Cummings,
said, "To be nobody-but-yourself---in a world which is doing
its best, night and day, to make you everybody else---means to fight
the hardest battle which any human being can fight ...."1
I agree with EE Cummings that people need help to fight the battles
of their lives, but first people must be aware of and accept these
battles before they can move on to conquer them. As David Spiegel,
MD, said in the April 14, 1999 issue of JAMA, "... Smyth
and colleagues demonstrate that merely writing about past stressful
life experiences results in symptom reduction among patients with
asthma or rheumatoid arthritis."2:1329 Reporting in
The MedServ Medical News on the same study by Smyth and colleagues,
Mara Bovsun concluded that "The simple act of writing about bad
times can be a potent, and low cost, method of relieving pain and
symptoms of chronic illnesses ...."3 This research
points out and supports the idea that emotions left unattended can
change into symptoms that cause confusion when they present in physicians'
offices. Through a weekly writing workshop offered by Kaiser Permanente's
Positive Choice Wellness Center in San Diego, people become aware
of their battles or issues, how to accept them, and how to move more
fully into a personal healing process.
Writing has
the Power to Heal
In his
book, Opening Up,4 James W Pennebaker, PhD, documented
his decades-long research into the healing effects of writing. Pennebaker
proved what many people have found incidentally through keeping a
journal or diary: If we can create a cohesive personal narrative of
our lives and if we can link up our emotions with specific events,
then we have the power to take control of how those emotions and events
affect our lives.
Although
many of us might be drawn to simply eliminate the pain in our lives,
those who constructively learn how to use that pain are often far
healthier than those who don't.4,5 Pennebaker noted that
the number of doctor office visits are reduced through the process
of writing. In her Medserv Medical News article, Bovsun quoted
Smyth and colleagues, "[a]lthough it may be difficult to believe
that a brief writing exercise can meaningfully affect health, this
study replicates what a burgeoning literature indicates in healthy
individuals," and then points out that "[t]he scientists
do not know why writing appears to help, but other research suggests
that it may bolster immune function and enhance ... ability to cope
with painful incidents."3
May
Sarton said that "... the only way through pain ... is to go
through it, to absorb, probe, understand exactly what it is and what
it means .... Nothing that happens to us, even the most terrible shock,
is unusable, and everything has somehow to be built into the fabric
of the personality ...."6 By using the different writing
forms--fiction, nonfiction, poetry, journaling, list-making, and others--we
can use the pain in our lives to further develop the "fabric
of our personality."6 Through writing, we try to find
order in the things that have happened to us; to use our writing as
a form of self-analysis; or to give form and sense to what has affected
us. Whichever form our writing takes, it has the power to heal us
and to help us grow.
Often
we form destructive attachments by putting energy into certain activities
that seem to give us either pleasure or relief. Writing helps us to
understand who we are and where and why we have formed such attachments.
Writing can then help us redirect our energy. Writing allows us to
get in touch with what is often hidden from us--whether it be the
reason behind our weight gain, a hard-to-understand addiction, a compulsion
we fight daily, or a pain we wish would go away. Writing helps us
to form connections with what is going on inside us and with others.
How Does Writing
Heal?
People
simply start by writing about a specific event or situation or relationship
that affected them. For example, a woman can begin by writing a letter
to her mother or father (that does not get sent) telling the parent
about the best and worst things the parent did for her. Or a man can
begin by writing about how he experiences the emotion of anger or
where in his body he actually feels the emotion of bitterness. People
must write freely; ideally, the writing is continued for at least
20 minutes without stopping. People should not edit what they are
writing; they shouldn't worry about grammar or punctuation or how
things might sound. They simply need to write and see what comes out;
and, according to Pennebaker, they must write about both the event
and the emotions surrounding that event.4
Although
the simple exercise of writing has actually been proven to decrease
blood pressure and improve immune functioning,4 reading
the work aloud and processing it with others can itself further enhance
the overall healing effects of writing. The ability to tell their
own story often gives people the first chance to really understand
that story. Many people have said that they didn't know what they
were going to write until it was written; another way of describing
this phenomenon is to say that the writing taps into their unconscious.
Healing through the written word happens when people learn about themselves
and open themselves to the healing power within.
For
example, here are pieces written during the "Healing Through
the Written Word" group at Positive Choice:
Emptiness
By Santo Messinab
Emptiness
stands,
Great breeze that tickles the skin,
Sounds give music harmony.
Seeing green that transforms into yellow
and bursting in red
tranquilized by orange,
then storming clouded haze gives way to
bright shining streaks
of rays that cut the clouds
and warm the skin.
Calmed by water dropping over soft melted stones
bleached by sun and coming slow
then fast
then big
then slow again
and
gone
and
quiet
and lull
and not
and fragrance breaks the quiet spell.
I meet
tranquility and love breaks through
And wetness strikes from nowhere known
without a signal, without knowing
and flood my eyes with sadness-joy
and quiet want
as
no one knows
my heart is deep and mended not
without a chance to consider why
as sudden chirp as feathers fly
and
land on foot to sobbing heaves
as though the flying friend knew, what lies within
as
I do not.
The
shriek of voices that comes outside
to violently thrust my pain aside
and dew drops must be hid or else
creatures know and floods will flow.
I cannot stop this flowing yet
I need to hide
so again I smile and brush my hair and know not where to shroud my
care.
I cannot stop
and still I hear the voice that comes outside
and is still afar.
I cannot stop
I will not stop.
The voice is louder and louder
not caring, it is slicing parts within me bleeding
and so I hear
and so I hear
I do not want to stop but still
I hear
and hear...............
Frozen In Time
By Diana Medlina
When
I was quite small I entered battle.
I did not have any weapons nor armor
To shield me.
All I had were my toys and my stuffed bear.
We
created our own foxhole and waited
Out the night.
We
did not dare sleep until it had stayed quiet
For a long time.
We held our breath together and looked out the window
Into the frozen midnight.
And
when it was safe to breathe we would
Press our faces up against the glass and
Marvel at the fading impression.
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Research
Shows Efficacy of Writing
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In
his 1990 book, Opening Up, James W Pennebaker, PhD, first
published his findings about how expressing emotions through
writing affects the immune system.4 On the basis
of what was to become years of research and study, Pennebaker
showed that " ... actively holding back or inhibiting our
thoughts and feelings can be hard work. Over time, the work
of inhibition gradually undermines the body's defenses. Like
other stressors, inhibition can affect immune function, the
action of the heart and vascular systems, and even the biochemical
workings of the brain and nervous systems. In short, excessive
holding back of thoughts, feelings, and behaviors can place
people at risk for both major and minor diseases."4:p2
Before
psychoneuroimmunology commanded the attention it does today,
Pennebaker worked with the research team of Janice K Kiecolt-Glaser
(a clinical psychologist) and Ronald Glaser (an immunologist)
to use "... precise, state-of-the-art techniques to measure
the action of T-lymphocytes, natural killer cells, and other
immune markers in the blood."4:p35 By taking
blood samples before, immediately after, and six weeks after
the writing experience, Pennebaker made inroads into measuring
the effects of self-expressive writing on the immune system.
Pennebaker
has conducted numerous studies to corroborate his original findings:
"When disclosing deeply personal experiences, there are immediate
changes in brainwave patterns, skin conductance levels ... after
confessions, significant drops in blood pressure and heart rate,
as well as improvements in immune function, occur. In the weeks
and months afterward, people's physical and psychological health
is improved."4:p56 Others (eg, Joshua M Smyth5
at North Dakota State University) have expanded on Pennebaker's
research to show that writing helps people who have chronic diseases,
such as asthma and arthritis
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Each
of these people has used writing as a way to get in touch with, understand,
and begin to heal from painful events. Specifically, by writing about
these experiences, these individuals are able to shift the power of
the event from the event or experience itself into their own hands.
As they write, they recreate the situation or event mentally and begin
to work with it. They gain access to their own feelings, sometimes
discovering feelings they didn't even know were there. People who
discover or uncover these feelings can begin to work through them.
Positive
Choice Wellness Center Includes Writing Workshops
In
the weekly writing group at KP's Positive Choice Wellness Center,
each person has an opportunity to share her or his writing with others.
Through empathetic listening and response, participants help each
other gain "... sufficient honesty to look at the inner self
... [and] enough objectivity to view a feeling or behavior pattern
from another perspective ...."7:p58 From this experience
of sharing and reflection, people often gain the self-confidence to
accept and understand their difficult issues and to process them more
thoroughly than ever before.
As
a group facilitator, I take the lead in listening with empathy and
understanding to help guide people through the often-difficult process
of recognizing important emotions and events that have long been left
unattended. By working with images and specific language that individuals
use, I can often identify behavioral patterns and issues that surface.
By gently probing into what their own writing uncovers, people often
come to believe that change is possible. Although neither the group
nor I try to tell people how they might change, we do create an environment
in which change is possible. Emotional change in these groups has
led to stress reduction and weight loss, both of which affect a person's
health and well-being. In this way, writing about events and emotions
and sharing these with others in a supportive environment is an example
of how powerful the healing effects of writing can be.
For
those not able to participate in the writing work-shop facilitated
by the KP Positive Choice Wellness Center in San Diego, the Web site
www.journalingmagazine.com
offers exercises, suggestions, and inspiration to those who want to
write. In addition, many books are available, such as Writing Your
Way to Healing and Wholeness by Robin B Dilley,8 which
invites people to write in a journal on a variety of topics; or Writing
as a Way of Healing by Louise DeSalvo,9 which shows
how effective a tool writing has been and continues to be for people.
a Reprinted by permission of the author.
b Reprinted by permission of the author.
References
-
Cummings EE. A poet's advice to students. In: Cummings EE. A miscellany
revised. New York: October House; 1965. p 335.
-
Spiegel D. Healing words: emotional expression and disease outcome
[editorial]. JAMA 1999 Apr 14;281(14):1328-9.
-
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Pennebaker JW. Opening up: the healing power of expressing emotions.
New York: Guilford Press; 1997.
-
Smyth JM, Stone AA, Hurewitz A, Kaell A. Effects of writing about
stressful experiences on symptom reduction in patients with asthma
or rheumatoid arthritis: a randomized trial. JAMA 1999 Apr 14;281(14):1304-9.
-
Sarton M. Recovering: a journal. New York: Norton; 1980. p 13.
-
Hynes AM, Hynes-Berry M. Bibliotherapy: the interactive process:
a handbook. Boulder (CO): Westview Press; 1986.
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Dilley RB. Writing your way to healing and wholeness: simple exercises:
exploring your past and changing your future. Glendale (AZ): Robin
B Dilley, PhD, Ltd; 1999.
-
DeSalvo L. Writing as a way of healing: how telling our stories
transforms our lives. Boston: Beacon Press; 1999.
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