Expressive Writing Therapy
Republished with permission of Natural Standards Research Collaboration ©2007


Expressive writing therapy may be an alternative source of healing for cancer patients, a new report suggests.

Researchers at Dana-Farber Cancer Institute and Harvard Medical School in Boston, MA found that expressive writing or journal therapy may boost mental and physical health in patients suffering from cancer.

Harvard researchers explained that many cancer patients turn to support groups, psychotherapy or antidepressant drugs to help them cope with the fears and challenges the illness brings.

Expressive writing or journal therapy offers an alternative to those treatments. Researchers suggest that by spending 30 minutes every day for four days writing out innermost thoughts and feelings, patients can significantly improve their health.

In expressive writing therapy, patients are encouraged to express whatever is on their mind, letting their hopes and fears flow out. This allows patients to better understand what may be bothering them or triggering stress.

Patients with the best results experienced a sense of release and found they were able to come to terms with some of their issues.

Researchers tracking the effects of journal therapy in patients with breast cancer noted that more that the typical 30 minutes per day of writing for four days may be required to see benefits and the therapy may not be effective in all patients.

Researchers concluded that standard 4-day therapy was effective in reducing physical symptoms.

In a related study, researchers at Skidmore College in Saratoga Springs, NY examined the role of expressive journal writing characteristics on mood over the course of a 12-week support group in 43 women newly diagnosed with breast cancer.

Writing was analyzed using the linguistic inquiry and word count program. Writing characteristics that were examined included: average word count, number of journal entries, positive and negative emotion words, the ratio of positive to negative words and the use of cognitive mechanism words (i.e. insight and causal words).

Regression analyses revealed that increased levels of anxiety and depression, post-intervention, were predicted by the prevalence of negative emotion in writing. Unique variance in mood (anxiety and depression) was accounted for by expression of negative emotion (seven and six percent, respectively).

The study found these relationships were significant and remained significant even after accounting for pre-intervention levels of distress, and for the quantity and frequency of writing.

Researchers concluded that additional research into the naturalistic application of journaling is needed so that appropriate recommendations for writing (e.g. focus, timing, amount) can be offered to patients who might choose to utilize this approach for coping with the stresses of cancer diagnosis and treatment.

And finally, a study conducted at the University of Texas M.D. Anderson Cancer Center examined 42 patients with metastatic renal cell carcinoma (kidney cancer). In the Phase II clinical trial, patients were randomly assigned to an expressive writing (EW) group or neutral writing (NW) group.

Patients in the EW group wrote about their cancer, and patients in the NW group wrote about health behaviors. No statistically significant differences were found regarding symptoms of distress, perceived stress or mood disturbance. However, patients in the EW group reported significantly less sleep disturbance, better sleep quality and sleep duration and less daytime dysfunction compared with patients in the NW group.

Researchers concluded that EW may have sleep-related health benefits in terminally ill cancer patients.

More studies are needed to confirm overall health benefits, mental and physical, of expressive journal writing in cancer patients. However, there is evidence at this time that expressive writing therapy may help cancer patients cope with stress, relieve anxiety and experience improvements in sleep quality and duration.

For more information on alternative and integrative therapies for cancer, please visit Natural Standard's Condition Center database.

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