Jane McCredie: Writing therapy

I clamped my teeth together, biting down hard. I now held the baby’s legs in my hands, with its head still inside Mathilde. Its blue feet hung down limply over my wrists, lolling to each side. “Come on,” I said to Mathilde. “Another push.”

READING GP Dr Susan Fox’s evocative story about her attendance at a difficult breech birth made me think about the way that writing can sometimes help us come to terms with distressing events.

The winning entry in the MJA Dr Eric Dark Creative Writing competition, Dr Fox’s crafted piece is of course much more than just writing as therapy.

But whether writing is designed to communicate to an audience as this one is, or simply to express feelings privately, it seems to hold a healing capacity for many of us.

Research into “expressive writing” suggests it can offer long-term health benefits in both general and clinical populations. Basically, the technique involves writing about a traumatic or emotional experience for 3‒5 sessions, often on consecutive days, for 15‒20 minutes each time.

It’s difficult to get robust findings in an area like this, particularly if studies measure self-reported outcomes, although it is possible to have a control group writing about a more neutral topic, such as their shoes or the room they are in.

In a review of the literature a few years ago, researchers from Sydney’s Black Dog Institute found that, while expressive writing could actually increase distress and physical symptoms in the short term, a body of research suggested long-term benefits in both self-reported and objectively assessed health outcomes.

Benefits had been found, for example, in the numbers of illness-related doctor visits, days in hospital, blood pressure, and lung, liver and immune system function. There were also improvements in educational, employment and sporting performance measures.

The benefits appeared to be greatest in those who were physically and psychologically healthy, and men might benefit more than women, the researchers suggested. In healthy people, the practice might be as helpful as other — more expensive and time-consuming — psychological interventions.

We don’t really know how the benefits are achieved. The Black Dog researchers evaluated a number of possible mechanisms without coming to any clear conclusion, though it did seem as though the reorganising and restructuring required to construct a coherent narrative might be part of the answer.

I wonder if doctors, and others who routinely face distressing or traumatic situations in the course of their work, might gain from incorporating this kind of writing into their weekly routine.

In particular, medical students and junior doctors might find it a useful way of coping with the more confronting aspects of clinical practice.

A lot of us probably poured out our angst in adolescent diaries, then gave up the practice as part of “growing up”. But maybe we’d actually be healthier adults if we dusted off those diaries again.

Jane McCredie is a Sydney-based science and medicine writer.

Posted 2 April 2012