••Summer 2006/Vol. 10, No. 2
Vohs and Lawrence Awards
Special Feature: Garfield Centennial

Book Reviews

Half Moon Bay (CA): Creekside Communications; 2005. ISBN 0-9766352-0-8, 160 pages; paperback $19.95

WellWriting for Health After Trauma and Abuse: Five WellWriting Ways to Regain Your Health and Life | to pdf >> by Ellen H Taliaferro, MD Reviewed by Vincent J Felitti, MD

An insight into the purpose of this unusual book is provided by the Swiss psychoanalyst, Alice Miller, in her observation, "The truth about childhood is stored up in our bodies .... Our intellects can be deceived, our feelings manipulated, our perceptions confused, and our bodies tricked with medication. But someday our body will present its bill ..."¹ WellWriting is a book designed to help difficult patients and, indirectly, their doctors.

In my early years of practice, at a time when I was furtively looking for help with difficult patients (regularly from radiologists), I was often troubled by the fact that so many of my patients didn't fit into the neat diagnostic categories described in Cecil² or Harrison.³ Moreover, there was no one to whom I could pass them on; no longer could I leave my problems behind by changing services. It never would have occurred to me that the patients themselves could be a resource, much less that their writing could be therapeutic.

The University of Texas psychologist, James Pennebaker, PhD, has studied and published convincingly on the benefits of autobiographical writing by patients.⁴ On several occasions in the past few years, autobiographical writing has been mentioned in JAMA⁵ as well as The Permanente Journal.^6-8 Following Professor Pennebaker's advice, I personally have found it effective to tell anxious, depressed, and somatizing patients that, before they return, I want them to start sending me by e-mail a detailed autobiography of their lives in five-year segments. This, they understand, will be held in a private computer file and not be part of their general record. Many comply and are benefited; the benefits are long term, not necessarily immediate. I have benefited by understanding more about these men and women and how their life experiences slowly have transmuted into illness or disease. Of course, a few do not write; it is frightening as well as helpful to expose the inner reality of one's life by telling someone else.

A small book has now been published that can help patients with this new task of autobiographical writing. Surprisingly, the book has been written by a former Professor of Surgery! WellWriting is gently written, easing patients into their task of autobiographical writing, and particularly re-writing, for this process helps memories re-develop and insights grow. Useful examples are given that enable readers to understand how life experiences translate into physical symptoms. Encouraging quotations are sprinkled throughout. Prompts are skillfully provided to encourage writing at length and in depth.

WellWriting is a well-conceived idea for a book. Not only is this small volume likely to help patients, it will undoubtedly help physicians increase their breadth of understanding of why patients see doctors, which is quite different from why doctors see patients. Doctors will come to appreciate how patients' retelling of their life stories allows them to become desensitized to past traumatic experiences and to rethink how life experiences can underlie illness. This is a good book to use if one wishes to learn new ways of helping patients deal with old problems.

References

1. Miller A. Thou shalt not be aware: society's betrayal of the child. Translated from the German by H and H Hannum; with a preface by L deMause and a new introduction by the author. New York: Farrar, Straus and Giroux; 1998, p 315.

2. Goldman L, Ausiello D, editors. Cecil textbook of medicine. 22nd ed. Philadelphia: WB Saunders; 2004.

3. Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL, editors. Harrison's principles of internal medicine. 16th ed. New York: McGraw-Hill Medical Publishing Division; 2005.

4. Pennebaker JW. Opening up: The healing power of expressing emotions. New York: The Guilford Press; 1997.

5. Spiegel D. Healing words: emotional expression and disease outcome [editorial]. JAMA 1999 Apr 14;281(14):1328-9.

6. Cangialosi K. Personal journaling: writing about your life. Perm J 2001 Summer;5(3):82.

7. Cangialosi K. Healing through the written word. Perm J 2002 Summer;6(3):68-70.

8. Felitti VJ. In the shadow of obesity--part 2. Perm J 2000 Fall;4(4):50-3.

 

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