For the purposes of our retreat, Leading Patients in Writing for Health, my colleague, Karen Jooste, MD and I use the terms writing to heal, writing for health, and writing for wellness interchangeably. How wellness and writing are connected is usually described under an umbrella term like writing to heal or writing for health and sometimes simply as expressive writing (EW) We make a distinction between these terms and casual journaling or journal writing in general because writing to heal practices are marked mostly by their carefully designed writing prompts, prompts that may point to specific health challenges or the wellness goals of individual patients or clients. A further distinction between casual journaling and writing to heal is how writing to heal practices are grounded in expressive writing research and techniques that encourage patients or clients to write in accordance with a progression of exercises from simple but deep emotional expression to an affirmation of strengths and intentional living.
Many of our distinctions between journaling and writing to heal practices are suggested in the wonderful synthesis of research and practices that Louise DeSalvo provides in her work, Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives. DeSalvo suggests that writing about trauma benefits health when it is rich in detail, balanced with feelings of the past, present, and future; and when it looks for linkage in the present and for meaning. Journaling that is simply keeping track of events or free-writing about those events has not been shown to improve health. Here is what DeSalvo describes are the qualities of a healing narrative:
- Renders our experiences concretely, authentically, explicitly, with a richness of detail;
- Links feelings to events;
- Is balanced in its use of positive language and negative language;
- Reveals insights we’ve achieved from our painful experience;
- Tells a complete, complex, coherent story (57-61).
We propose in Leading Patients in Writing for Health that writing is one tool in a toolbox of integrative medicine or complimentary medicine and that it may be a useful tool for you in your practice, but it is certainly not a one-size-fits-all prescription. Writing to heal may take many forms because therapeutic value is found when literary genres such as memoirs, essays, fiction, poetry, drama are framed in such a way to build on the writer’s life experience, health challenges and goals for well-being. Whether you ever read what your client or patient writes is not as important or as necessary as how they reflect on their writing. In fact sharing does not improve the positive affect writing can have on the writer.
Writing to heal is safe, inexpensive, and accessible to almost everyone. It only has one rule: The three-day rule. Advise your patients to watch out for writing themselves into a rut. Please explain to them that if they find themselves covering the same ground over and over with the same emotion, it may be time to move on. Either write about the topic in an entirely different way or leave the topic alone for a while.
In further articles in this series, we will explain the principles and defining characteristics of five types of writing to heal known as Expressive, Transactional, Poetic, Affirmative and Legacy, and we will demonstrate how writing and mindfulness are connected through Six As of Mindful Writing: awareness, attention, acceptance, affection, appreciation, and affirmation.