creative writing and therapy

Writing Therapy: How to Write and Journal Therapeutically

Of course, the answer to that question will be “yes” for everyone!

We all fall on hard times, and we all struggle to get back to our equilibrium.

For some, getting back to equilibrium can involve seeing a therapist. For others, it could be starting a new job or moving to a new place. For some of the more literary-minded or creative folks, getting better can begin with art.

There are many ways to incorporate art into spiritual healing and emotional growth, including drawing, painting, listening to music, or dancing. These methods can be great for artistic people, but there are also creative and expressive ways to dig yourself out of a rut that don’t require any special artistic talents.

One such method is writing therapy. You don’t need to be a prolific writer, or even a writer at all, to benefit from writing therapy. All you need is a piece of paper, a pen, and the motivation to write.

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This Article Contains:

• What Is Writing Therapy?

Benefits of Writing Therapy

How to: journaling for therapy, writing ideas & journal prompts, exercises and ideas to help you get started, a take-home message, what is writing therapy.

Writing therapy, also known as journal therapy, is exactly what it sounds like: writing (often in a journal)  for therapeutic benefits.

Writing therapy is a low-cost, easily accessible, and versatile form of therapy . It can be done individually, with just a person and a pen, or guided by a mental health professional. It can also be practiced in a group, with group discussions focusing on writing. It can even be added as a supplement to another form of therapy.

Whatever the format, writing therapy can help the individual propel their personal growth , practice creative expression, and feel a sense of empowerment and control over their life (Adams, n.d.).

It’s easy to see the potential of therapeutic writing. After all, poets and storytellers throughout the ages have captured and described the cathartic experience of putting pen to paper. Great literature from such poets and storytellers makes it tempting to believe that powerful healing and personal growth are but a few moments of scribbling away.

However, while writing therapy seems as simple as writing in a journal , there’s a little more to it.

Writing therapy differs from simply keeping a journal or diary in three major ways (Farooqui, 2016):

• Writing in a diary or journal is usually free-form, where the writer jots down whatever pops into their head. Therapeutic writing is typically more directed and often based on specific prompts or exercises guided by a professional.
• Writing in a diary or journal may focus on recording events as they occur, while writing therapy is often focused on more meta-analytical processes: thinking about, interacting with, and analyzing the events, thoughts, and feelings that the writer writes down.
• Keeping a diary or journal is an inherently personal and individual experience, while journal therapy is generally led by a licensed mental health professional.

While the process of writing therapy differs from simple journaling in these three main ways, there is also another big difference between the two practices in terms of outcomes.

These are certainly not trivial benefits, but the potential benefits of writing therapy reach further and deeper than simply writing in a diary.

For individuals who have experienced a traumatic or extremely stressful event, expressive writing guided purposefully toward specific topics can have a significant healing effect. In fact, participants in a study who wrote about their most traumatic experiences for 15 minutes, four days in a row, experienced better health outcomes up to four months than those who were instructed to write about neutral topics (Baikie & Wilhelm, 2005).

Another study tested the same writing exercise on over 100 asthma and rheumatoid arthritis patients, with similar results. The participants who wrote about the most stressful event of their lives experienced better health evaluations related to their illness than the control group, who wrote about emotionally neutral topics (Smyth et al., 1999).

Expressive writing may even improve immune system functioning, although the writing practice may need to be sustained for the health benefits to continue (Murray, 2002).

In addition to these more concrete benefits, regular therapeutic writing can help the writer find meaning in their experiences, view things from a new perspective, and see the silver linings in their most stressful or negative experiences (Murray, 2002). It can also lead to important insights about yourself and your environment that may be difficult to determine without focused writing (Tartakovsky, 2015).

Overall, writing therapy has proven effective for different conditions and mental illnesses, including (Farooqui, 2016):

• Post-traumatic stress
• Obsessive-compulsive disorder
• Grief and loss
• Chronic illness issues
• Substance abuse
• Eating disorders
• Interpersonal relationship issues
• Communication skill issues
• Low self-esteem

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There are many ways to begin writing for therapeutic purposes.

If you are working with a mental health professional, they may provide you with directions to begin journaling for therapy.

While true writing therapy would be conducted with the help of a licensed mental health professional, you may be interested in trying the practice on your own to explore some of the potential benefits to your wellbeing. If so, here there are some good tips to get you started.

First, think about how to set yourself up for success:

• Use whichever format works best for you, whether it’s a classic journal, a cheap notebook, an online journaling program, or a blog.
• If it makes you more interested in writing, decorate or personalize your journal/notebook/blog.
• Set a goal to write for a certain amount of time each day.
• Decide ahead of time when and/or where you will write each day.
• Consider what makes you want to write in the first place. This could be your first entry in your journal.

Next, follow the five steps to WRITE (Adams, n.d.):

• W – What do you want to write about? Name it.
• R – Review or reflect on your topic. Close your eyes, take deep breaths, and focus.
• I – Investigate your thoughts and feelings. Just start writing and keep writing.
• T – Time yourself. Write for five to 15 minutes straight.
• E – Exit “smart” by re-reading what you’ve written and reflecting on it with one or two sentences

Finally, keep the following in mind while you are journaling (Howes, 2011):

• It’s okay to write only a few words, and it’s okay to write several pages. Write at your own pace.
• Don’t worry about what to write about. Just focus on taking the time to write and giving it your full attention.
• Don’t worry about how well you write. The important thing is to write down what makes sense and comes naturally to you.
• Remember that no-one else needs to read what you’ve written. This will help you write authentically and avoid “putting on a show.”

It might be difficult to get started, but the first step is always the hardest! Once you’ve started journaling, try one of the following ideas or prompts to keep yourself engaged.

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Here are five writing exercises designed for dealing with pain (Abundance No Limits, n.d.):

• Write a letter to yourself
• Write letters to others
• Write a poem
• Free write (just write everything and anything that comes to mind)
• Mind map (draw mind maps with your main problem in the middle and branches representing different aspects of your problem)

If those ideas don’t get your juices flowing, try these prompts (Farooqui, 2016):

• Journal with photographs – Choose a personal photo and use your journal to answer questions like “What do you feel when you look at these photos?” and “What do you want to say to the people, places, or things in these photos?”
• Timed journal entries – Decide on a topic and set a timer for 10 or 15 minutes to write continuously.
• Sentence stems – These prompts are the beginnings of sentences that encourage meaningful writing, such as “The thing I am most worried about is…” “I have trouble sleeping when…” and “My happiest memory is…”
• List of 100 – These ideas encourage the writer to create lists of 100 based on prompts like “100 things that make me sad” “100 reasons to wake up in the morning,” and “100 things I love.”

Tartakovsky (2014) provides a handy list of 30 prompts, including:

• My favorite way to spend the day is…
• If I could talk to my teenage self, the one thing I would say is…
• Make a list of 30 things that make you smile.
• The words I’d like to live by are…
• I really wish others knew this about me…
• What always brings tears to your eyes?
• Using 10 words, describe yourself.
• Write a list of questions to which you urgently need answers.

If you’re still on the lookout for more prompts, try the lists outlined here .

6 Ways to process your feelings in writing – Therapy in a Nutshell

As great as the benefits of therapeutic journaling sound, it can be difficult to get started. After all, it can be a challenge to start even the most basic of good habits!

If you’re wondering how to begin, read on for some tips and exercises to help you start your regular writing habit (Hills, n.d.).

• Start writing about where you are in your life at this moment.
• For five to 10 minutes just start writing in a “stream of consciousness.”
• Start a dialogue with your inner child by writing in your nondominant hand.
• Cultivate an attitude of gratitude by maintaining a daily list of things you appreciate, including uplifting quotes .
• Start a journal of self-portraits.
• Keep a nature diary to connect with the natural world.
• Maintain a log of successes.
• Keep a log or playlist of your favorite songs.
• If there’s something you are struggling with or an event that’s disturbing you, write about it in the third person.

If you’re still having a tough time getting started, consider trying a “mind dump.” This is a quick exercise that can help you get a jump start on therapeutic writing.

Researcher and writer Gillie Bolton suggests simply writing for six minutes (Pollard, 2002). Don’t pay attention to grammar, spelling, style, syntax, or fixing typos – just write. Once you have “dumped,” you can focus on a theme. The theme should be something concrete, like something from your childhood with personal value.

This exercise can help you ensure that your therapeutic journal entries go deeper than superficial diary or journal entries.

More prompts, exercises, and ideas to help you get started can be found by following this link .

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In this piece, we went over what writing therapy is, how to do it, and how it can benefit you and/or your clients. I hope you learned something new from this piece, and I hope you will keep writing therapy in mind as a potential exercise.

Have you ever tried writing therapy? Would you try writing therapy? How do you think it would benefit you? Let us know your thoughts in the comments!

Thanks for reading, and happy writing!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Abundance No limits. (n.d.). 5 Writing therapy exercises that can ease your pain . Author. Retrieved from https://www.abundancenolimits.com/writing-therapy-exercises/.
• Adams, K. (n.d.). It’s easy to W.R.I.T.E . Center for Journal Therapy . Retrieved from https://journaltherapy.com/journal-cafe-3/journal-course/
• Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment 11(5) , 338-346.
• Farooqui, A. Z. (2016). Journal therapy . Good Therapy . Retrieved from https://www.goodtherapy.org/learn-about-therapy/types/journal-therapy
• Hills, L. (n.d.). 10 journaling tips to help you heal, grow, and thrive . Tiny Buddha . Retrieved from https://tinybuddha.com/blog/10-journaling-tips-to-help-you-heal-grow-and-thrive/
• Howes, R. (2011, January 26). Journaling in therapy . Psychology Today. Retrieved from https://www.psychologytoday.com/blog/in-therapy/201101/journaling-in-therapy.
• Murray, B. (2002). Writing to heal. Monitor, 33(6), 54. Retrieved from http://www.apa.org/monitor/jun02/writing.aspx
• Pollard, J. (2002). As easy as ABC . The Guardian . Retrieved from https://www.theguardian.com/lifeandstyle/2002/jul/28/shopping
• Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Journal of the American Medical Association 281 , 1304-1309.
• Tartakovsky, M. (2014). 30 journaling prompts for self-reflection and self-discovery . Psych Central . Retrieved from https://psychcentral.com/blog/archives/2014/09/27/30-journaling-prompts-for-self-reflection-and-self-discovery/
• Tartakovsky, M. (2015). The power of writing: 3 types of therapeutic writing . Psych Central . Retrieved from https://psychcentral.com/blog/archives/2015/01/19/the-power-of-writing-3-types-of-therapeutic-writing/

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Article feedback

What our readers think.

Hello, Such an interesting article, thank you very much. I was wondering if there was a particular strategy in which writing down questions produced answers. I started doing just that: writing down doubts and questions, and I found that answers just came. It was like talking through the issues with someone else. Is there any research on that? Is this a known strategy?

Hi Michael,

That’s amazing that you’re finding answers are ‘arising’ for you in your writing. In meditative and mindfulness practices, this is often referred to as intuition, which points to a form of intelligence that goes beyond rationality and cognition. This is a fairly new area of research, but has been well-recognized by Eastern traditions for centuries. See here for a book chapter review: https://doi.org/10.4337/9780857936370.00029

As you’ve discovered, journaling can be incredibly valuable to put you in touch with this intuitive form of knowing in which solutions just come to you.

This also reminds me of something known as the rubber ducking technique, which programmers use to solve problems and debug code: https://en.wikipedia.org/wiki/Rubber_duck_debugging

Anyway, hope that offers some food for thought!

– Nicole | Community Manager

I have never tried writing therapy, but I intend to. Its so much better than seeing the psychiatrist for my behavior issues, which nobody has even identified yet.

Hi great article, just wondering when it was originally posted as I wish to cite some of the text in my essay Many thanks

Glad you enjoyed the post. It was published on the 26th of October, 2017 🙂

Hope this helps!

Hi Courtney

I know you posted this blog a while ago but I’ve just found it and loved it. It articulated so clearly the benefits of writing therapy. One question – is there any research on whether it’s better to use pen and paper or Ian using a PC/typing just as good. I can write much faster and more fluently when I use a keyboard but wonder whether there is a benefit from the physical act of writing writing with a pen. Thanks.

Great question. The evidence isn’t entirely clear on this, but there’s a little work suggesting that writing by hand forces the mind to slow down and reflect more deeply on what’s being written (see this article ). Further, the process of writing uses parts of the brain involved in emotion, which may make writing by hand more effective for exploring your emotional experiences.

However, when it comes to writing therapy, the factor of personal preference seems critical! The issue of speed can be frustrating if your thoughts tend to come quickly. If you feel writing by hand introduces more frustration than benefits, that may be a sign to keep a digital journal instead.

Hope that helps!

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Writing Can Help Us Heal from Trauma

• Deborah Siegel-Acevedo

Three prompts to get started.

Why does a writing intervention work? While it may seem counterintuitive that writing about negative experiences has a positive effect, some have posited that narrating the story of a past negative event or an ongoing anxiety “frees up” cognitive resources. Research suggests that trauma damages brain tissue, but that when people translate their emotional experience into words, they may be changing the way it is organized in the brain. This matters, both personally and professionally. In a moment still permeated with epic stress and loss, we need to call in all possible supports. So, what does this look like in practice, and how can you put this powerful tool into effect? The author offers three practices, with prompts, to get you started.

Even as we inoculate our bodies and seemingly move out of the pandemic, psychologically we are still moving through it. We owe it to ourselves — and our coworkers — to make space for processing this individual and collective trauma. A recent op-ed in the New York Times Sunday Review affirms what I, as a writer and professor of writing, have witnessed repeatedly, up close: expressive writing can heal us.

• Deborah Siegel-Acevedo is an author , TEDx speaker, and founder of Bold Voice Collaborative , an organization fostering growth, resilience, and community through storytelling for individuals and organizations. An adjunct faculty member at DePaul University’s College of Communication, her writing has appeared in venues including The Washington Post, The Guardian, and CNN.com.

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Ultimate Guide to Creative Writing Therapy (with Writing Therapy Prompts)

March 22, 2023

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Creative writing therapy, or therapeutic writing is a form of therapeutic intervention that uses writing as the tool to explore and express your thoughts, feelings and emotions. It’s also known as journal therapy – and it’s essentially the art of writing in a journal to heal yourself. 

Writing therapy can be a useful tool for people who struggle with mental health, have experienced trauma or grief, or are simply looking for a creative outlet to process their thoughts and feelings. Today we’re going to explore what creative writing therapy is, how it works, and the potential benefits of writing therapy. We’ll also share writing therapy prompts to help you get started and explore writing therapy today. 

Please keep in mind that there is no true substitute for seeing a licensed therapist, and if you feel like you could benefit from talking to someone and getting help with what you’re going through – you’re not alone! There are tons of incredible therapists out there to help you. Here at Made with Lemons we’re big advocates for therapy and if you’d like a more inside scoop to our own journey with therapy, join On Your Terms . It’s a wellness newsletter that shares a more inside look to our own wellness journey as well as tools to help you along yours. Learn more about On Your Terms here.

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What is Creative Writing Therapy?

Writing therapy, also known as therapeutic writing, is a form of creative and expressive therapy that involves writing about your personal experiences, thoughts and feelings. It can take many forms, including journaling, poetry, creative writing, letter writing, or memoirs. Writing therapy can be done individually or in a group setting. It can also be facilitated by a therapist, counselor or writing coach.

The purpose of creative writing therapy is to help you express and process your emotions in a safe and supportive environment. It’s helpful to be able to write out your thoughts and feelings that might be hard to articulate in other ways. 

You might also see therapeutic writing used to help explore issues that are difficult to discuss in traditionally talking therapy sessions. And when your therapist invites you to try writing therapy, it’s also used in conjunction with other forms of therapy, such as trauma-focused therapy, to enhance its effectiveness. 

An example of creative writing therapy could be writing a letter to a person who hurt you, and then shredding or burning the letter to release some of the hurt and anger. 

How Does Therapeutic Writing Work?

Writing therapy works by allowing individuals to express their thoughts and feelings in a way that is both private and creative. The act of writing can help you organize your thoughts and gain clarity on your emotions. Writing can also be a way to release pent-up emotions and relieve stress. 

For example, if you’re feeling stressed after a long day of work, taking a few moments to write down what’s stressing you out and allowing yourself to let it go, can help you have a calm and more relaxing evening. 

Writing therapy should be a truly non judgemental space. It’s a time to write without worrying about grammar, punctuation, or spelling. The goal here is to let words flow freely, without judgment or criticism. Creative writing therapy sessions can be structured or unstructured, and sometimes it’s helpful to use prompts or exercises to help you get started. (i.e. what in your life is bringing you the most anxiety, or writing a letter to your friend to express ___________ hurt you when they said that.)

Oftentimes we find it easier to write about our hurt, our pain and the experiences that caused that, as opposed to opening up to talk about those things. In this way, writing can be a way to explore and process complex emotions such as grief or anger in a safe and supportive environment, where no one can get hurt further by what’s being felt and expressed. 

Potential Benefits of Writing Therapy

Now let’s talk about some of the benefits of therapeutic writing. 

Improved mental health

Writing therapy can be a tool that helps you manage symptoms of depression, anxiety and other mental health conditions. You can use journaling therapy to express and process difficult emotions, which over time can lead to improved mental regulation and a better sense of control over your thoughts and feelings. 

Increased self-awareness

Creative writing therapy can help you gain a better insight into your thoughts and behaviors. By reflecting on your experiences through writing, you can start to identify patterns and gain an understanding of yourself. 

Stress relief

Therapeutic writing can be a way to relieve stress and reduce anxiety. Writing is often cathartic, allowing you to release pent-up emotions and start to feel relief from things that would otherwise feel overwhelming. 

Improved communication skills

Journal therapy can also help you improve your overall communication skills. When you practice expressing yourself through writing, you can develop more confidence to communicate more effectively in both your personal and professional relationships. In essence, writing your feelings can help you communicate them better when needed. 

Increased creativity

Lastly, creative writing therapy can also be a way to tap into your creativity and imagination. We talk a lot about your inner child around here, and journal therapy can be another helpful way you can interact with your inner child. Through writing you can explore new ideas and perspectives, leading to your own personal growth.

How to try Creative Writing Therapy Today

Now let’s talk about how you can try therapeutic writing for yourself today. These tips are going to help you get started with writing therapy from home, as a personal activity to help heal yourself. 

Set aside dedicated time for writing therapy

Like most self improvement and self care techniques, it helps to set aside a dedicated time to write regularly. We know this can be a challenging task, especially if you’re struggling with mental health issues or challenges in your life. A good place to start is to set aside a few minutes each evening to write and decompress from your day. It can be just 2 minutes before bed. Remember, therapeutic writing is a non judgemental activity, so the amount of time you dedicate isn’t important, it’s just important to show up for yourself. 

Find a quiet and comfortable space

Find a place that’s quiet and comfortable, and where you can write without interruptions. Some people find it helpful to create a writing ritual, such as lighting a candle or playing soft music to create a sense of calm and focus. Find what works for you, in a space where you can be alone for a few minutes. 

Choose a writing therapy prompt or topic

At the end of this guide we’re going to share writing therapy prompts to help you explore creative writing therapy and give you a starting point. You can also talk to your therapist to get prompts, or find some online. Prompts can be general, such as “write about what makes  you grateful or happy”, while others can be more specific, such as “write about a time that you felt overwhelmed.”

Write freely and without judgment

The most important thing about writing therapy is to write freely, without judging yourself. Allow yourself to write without worrying about grammar, punctuation or spelling. Don’t put a time limit on your writing, or feel like you have to write a certain number of words or pages. The goal here is to allow your thoughts and emotions to flow freely without any judgment at all. 

Write honestly and openly

Along with being judgment free, it’s also so important that you write honestly and openly. Writing therapy is a space for honesty and openness. This space is created for you to share your thoughts and emotions, even if they're difficult or uncomfortable to confront. Just be open to exploring them, and remember that you don’t have to share this with anyone, so it’s a space where you can be fully honest with yourself. 

Reflect on your writing

After writing, you can take a few moments to reflect on what you have written. It might even be helpful to come back to what you have written at another time, when you have a clear head or have left the emotions behind. This can help you consider the emotions and patterns that you have expressed. Doing this reflection can help you gain more insight into your thinking patterns and emotions for future sessions. 

Consider sharing your writing with a therapist or counselor

Lastly, consider sharing your writing with a therapist or counselor. They can help you process emotions and gain a deeper understanding of yourself. Sharing your writing can also help you feel less alone in your struggles and provide important validation for your experiences. 

20 Writing Therapy Prompts

• When do I feel the most like myself?
• How do I feel at this moment?
• What do I need more of in my life?
• What do I look forward to every day?
• What is a lesson that I had to learn recently?
• Based on my daily routine, where do I see myself in 5 years?
• What don’t I regret?
• What would make me happy right now?
• What has been the hardest thing to forgive myself for?
• What’s bothering me? And why?
• What do I love about myself?
• What are my priorities right now?
• What does my ideal day look like?
• What does my ideal morning look like? Evening?
• Make a list of 30 things that make you smile
• Make a gratitude list
• The words I’d like to live by are…
• I really wish others knew this about me…
• What always brings tears to my eyes?
• What do I need to get off my chest today?

Creative writing therapy can be a powerful tool for exploring and processing thoughts and emotions. When you set aside a dedicated time to write, and create a safe and supportive space for yourself, you can gain insight into your emotions and develop better tools to manage them. With practice and commitment, writing therapy can become a habit for your self care routine. 

If you’d like to build the habit of writing therapy in your own life, then we’d like to invite you to download our habit tracker. It’s super easy to use, beautifully designed and completely free. All you need is a google account to access it. Grab a copy of our habit tracker here.

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How to Use Writing Therapy to Release Negative Emotions and Trauma

Whether it’s lyrics or journaling—expression through writing can be cathartic

Verywell / Julie Bang

• What to Know About Writing Therapy

The Major Benefits of Writing Therapy

• How to Get Started With Expressive Writing

Every Friday on  The Verywell Mind Podcast , host Minaa B., a licensed social worker, mental health educator, and author of "Owning Our Struggles," interviews experts, wellness advocates, and individuals with lived experiences about community care and its impact on mental health.

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Putting pen to paper feels a bit like an anomaly in a world obsessed with texting, tweeting, and sliding into people’s DMs. But let’s try something different. The next time you’re in your Notes app, give your thumbs a break and grab a pen and piece of paper instead. If you don’t have any paper handy, grab that Starbucks receipt and start writing whatever you were about to type. See how it feels. 

It might feel a bit awkward at first, especially if you haven’t had to physically write anything down in a long while. But as you keep writing, you may feel really engaged with the words you’re jotting down. Tapping letters on a screen isn’t the same as drawing out each letter of every word. Writing things down will inherently bond you to the words you write. And because of that, writing becomes quite powerful for the psyche . Aside from being a feel-good activity, writing can also let us process negative emotions and trauma in what turns out to be a pretty soul-cleansing experience. 

In fact, singer/songwriter and season three winner of The Voice, Cassadee Pope , seconds this. Pope, who's been in the music industry since she was 11 years old, has been pretty open about her mental health struggles—from bad breakups to the emotional impact of her parent’s divorce. Pope told Minaa B., LMSW , host of The Verywell Mind Podcast, “I needed an outlet with everything that was happening with my family. So that was really what I leaned on most, was songwriting.”

Now, you don’t have to be a gifted songwriter to reap the benefits of writing, but let's talk about why writing can be so good for your mental health. 

At a Glance

Writing can be a powerful therapeutic tool. Getting your thoughts down can help you understand them and process them more effectively than keeping them all in your head. People who use writing therapy report better overall mood and fewer depressive symptoms. If you’re struggling with a mental health condition and need to vent your frustrations—consider making a journal your new BFF.

What to Know About Writing Therapy (Write This Down)

Writing therapy (aka emotional disclosure or expressive writing) is pretty much exactly what it sounds like. It involves using writing of any kind, like creative writing, freewriting, and poetry, as a therapeutic tool. Writing therapy can be especially for those who are more withdrawn or have trouble opening up to others.

Writing therapy can be so beneficial to our mental health because it’s basically a form of venting. You know how good it feels to come home after a long day of work and go on and on about how much you dislike that one coworker for a reason you can’t even put your finger on. Or when you spill all of your dating frustrations to your bestie over the phone. It’s a nice release of stress. You can release stress in a similar way when you write, too. Just pretend that piece of paper is your therapist, closest confidante, or even yourself. 

No one else has to know whatever you choose to jot down (or rage-write about). Your journal or diary is your personal safe haven, and your innermost thoughts are safe on those pages. 

Research shows that writing about painful experiences can even improve your immune system. Getting all of your thoughts out on paper is a big stress reliever. It’s also known that trying to suppress negative emotions can be detrimental to your overall well-being, so verbal release may only help you in the long run. Another advantage of writing therapy is that it gives your emotions and thoughts some structure. For instance, my therapist knows I love writing—especially writing poetry. So, when I was dealing with a particularly traumatic time in my life, she told me that my next few homework assignments would be to write poetry about my feelings. Because poetry is a form of creative writing, I had to really think about the diction and imagery I wanted to convey in the poems.

As a result, I really had to unpack my feelings so that my poem would paint a clear picture of what I was going through. I worked on the poem each night before bed and had it ready for my next weekly session.

The next day, I hopped online to meet with my therapist and tell her I had completed my assignment. In response, she asked me to read it aloud. What?! I quickly grew nervous since I was not expecting that. But, considering she’s never led me astray, I reluctantly recited my poem. It was an emotional experience, and my voice audibly cracked a few times, but it felt really good—euphoric, even. So when Pope says that singing her lyrics is "cathartic," I completely get it. She says her singing can be a bit “disarming” because “ I’m believing every word so intensely, and I feel them so intensely.” 

So, not only does writing release some deep-seated feelings, orating them breathes life into them. There’s this particularly beautiful Chinese proverb that says: ‘I hear and I forget, I see and I remember, I write and I understand.’ Once our thoughts are written down, we can see them in front of us, through this practice they become real. Then, we can dig in and unpack what it all means to us.

Other Benefits of Writing Therapy

If you’re still not convinced about the power of writing, here are some other amazing benefits of writing to take note of (pun intended):

• Lowered blood pressure
• Reduced anxiety and depression symptoms
• Improved cognition
• Increased antibody production 
• Better overall mood

Ready to Get Started With Expressive Writing?—Here’s How

The great thing about writing is that it can be about anything you want. There are zero restrictions on what you can say. If you’ve had an upsetting experience or need to release some frustrations about daily stressors, try writing about it.

Pope talks about how she’s been using songwriting to get more authentic about her life as of late. In fact, she was kind enough to dish on the details about a new song of hers that’s set to release soon titled “Three of Us.” In this track, she details what it’s like being the “third wheel” when you’re in a relationship with someone who’s dealing with a substance use disorder : “It's about me, you, and the drugs.” In describing the lyrics, she says, “It's probably the most revealing song I've ever released.” 

Now, if you’ve already got an experience you want to write about, feel free to get started when you’re alone and in a private space. But if you don’t know where to start, here are some prompts to start flexing your writing muscles. 

Writing Prompts to Help You Get to Know Yourself Better

When you’re ready, get something to write with and a blank sheet of paper. Here are some prompts you can use to get started: 

• What does the perfect day look like for you? Think about the activities you’d engage in and who you would be spending your time with. Try engaging your five senses to dive deep into your imagination. 
• Write a story about the last time you were embarrassed. This time, reframe the experience into a positive one where you learn something new about yourself.
• Think about the best piece of advice you've ever received from someone. How has it helped to shape your life?
• Write a song or a poem about what it’s like to eat your favorite dessert. Consider the flavors, textures, and how you feel when you eat this specific treat. Where are you eating it? Did someone special make it for you, or did you make it yourself?
• What does self-love really mean to you? Who taught you what loving yourself looks like? What have you learned to embrace about yourself?
• If you’ve experienced a painful event, free-write about it. Don’t worry about grammar, spelling, or legibility—just write whatever comes to mind. You can even draw if that helps. 

These writing prompts should get you more comfortable with expressing your feelings. Once you make sense of your own experiences, you might be ready to share them with friends, significant others, and other people you trust. If you have a therapist or plan to start therapy, you’ll already have some material to share that you can explore in the session. 

When you connect through storytelling, you begin to strengthen your support network. Pope shared how much she leaned on her friends after a bad breakup. “ If you have community, lean into it and don't be afraid that someone's gonna judge you if you made a mistake or a bad decision, a poor decision, don't be afraid of that. It's so much more healthy to just let it out,” she says.

Pope also cautions that doing this can also reveal the people who accept you just as you are—flaws included: “ If somebody judges you or tries to make you feel bad about it, then OK, great. That one person is not a safe space for you.”

What This Means For You

If you’re uncomfortable opening up to your friends this way, that’s perfectly fine. Never feel pressured to share some uncomfortable thoughts or experiences. You can keep them to yourself in your journal or reserve them all for your therapist.

Writing is a good place to start when you want to better understand who you are and how your experiences have affected you. If you’re struggling with processing your emotions and feel that you need someone to talk to, consider seeing a mental health professional.

Mugerwa S, Holden JD. Writing therapy: a new tool for general practice? . Br J Gen Pract . 2012;62(605):661-663. doi:10.3399/bjgp12X659457

American Psychological Association. Writing to heal .

Krpan KM, Kross E, Berman MG, Deldin PJ, Askren MK, Jonides J. An everyday activity as a treatment for depression: the benefits of expressive writing for people diagnosed with major depressive disorder . J Affect Disord . 2013;150(3):1148-1151. doi:10.1016/j.jad.2013.05.065

By Ayana Underwood Ayana is the Associate Editor at Verywell Mind, where she aims to publish mental health content that is both engaging and of high quality.

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Writing therapy: types, benefits, and effectiveness, thc editorial team august 7, 2021.

In this article

What Is Writing Therapy?

How does writing therapy work, types of writing therapy, potential benefits of writing therapy, conditions treated by writing therapy, summary and outlook.

Writing therapy, or “expressive writing,” is a form of expressive therapy in which clients are encouraged to write about their thoughts and feelings—particularly those related to  traumatic  events or pressing concerns—to reap benefits such as reduced stress and improved physical health. 1  Writing therapy may be used in many environments, including in person or  online . It may be supervised by a mental health professional or even occur with little or no direct influence from a counselor. There are several types of writing therapy, including, but not limited to narrative therapy, interactive journaling, focused writing, and songwriting. Although traditional  psychotherapy , or talk therapy, has been standard practice in many therapeutic and counseling environments, evidence shows that writing therapy has many potential physical and psychological health benefits. 2

What Is the History of Therapeutic Writing / Expressive Writing?

Humans have expressed belief in the healing power of the written word since ancient times. For example, in the fourth century B.C.E., certain groups in Egypt believed that ingesting meaningful words written on papyrus would bring about health benefits. Words were thought to have medicinal and magical healing powers, so much so that inscribed above Egypt’s famed library of Alexandria was the phrase “The Healing Place of the Soul.” 1

However, the roots of modern therapeutic writing may be found in  bibliotherapy , a form of therapy that employs literature and reading to help people deal with challenges in their own lives. 3  This practice dates back to the fifth century B.C.E. when it was thought to cure a condition called melancholia, or a deeply experienced  depression .

More recently, writing therapy gained momentum in the United States in the early 19th century, 1  and it was popularized in the early 20th century with psychoanalyst Sigmund Freud’s  Creative Writers and Day Dreaming.  Though talk therapy was still the go-to approach, writing therapy gained steam in the 1930s and 1940s as creative therapies involving the  arts , such as music, dance, and writing grew. The 1965 American Psychological Association (APA) convention, held in Chicago, Illinois, hosted a symposium that focused on written communications with clients. This symposium, organized by a division of the APA called Psychologists Interested in the Advancement of Psychotherapy, generated a boom in writing therapy research in the 1970s. 1

In the 1980s, social psychologist James Pennebaker emerged as a leading advocate and researcher of writing therapy. His research focused on the benefits of writing about or discussing one’s emotional disturbances, including reduced stress and improved immune function. He also claimed that writing about traumatic events could help people cope. His work helped propel writing therapy into the mainstream of psychotherapeutic practice. 1

There are two main theories as to how writing therapy works. The first posits that inhibition or suppression of  emotions , traumatic events, or aspects of one’s identity constitutes a long-term, low-level stressor and has adverse health effects, such as an increased likelihood of becoming ill. Writing therapy can serve as an act of disclosure, and of written emotional expression, and therefore remove the stressor. However, this theory has become less accepted because research has shown that different acts of expression do not reap the same health benefits as writing therapy. 4

For example, Pennebaker conducted a study in 1996 in which one group of participants was asked to express a traumatic experience through physical movement, and another group was asked to express themselves through both physical movement and writing. Only the group that used both movement and writing showed significant physical health improvements. Pennebaker found that the specific language used while writing is associated with the physical and mental health benefits. When people’s emotional writing compositions were analyzed by judges and by the Linguistic Inquiry and Word Count software, positive emotion words like “happy” and a moderate number of negative emotion words like “sad” were associated with good physical health, while high and low levels of negative emotion words were associated with poor physical health. Compositions that showed an increase in causal words like “reason” and insight words like “realize” showed the most improved physical health in their writers. 4

When engaging in writing therapy, clients are asked to write about a traumatic experience. A standard practice might involve writing for 15 to 20 minutes for three consecutive days. 5  A 2002 study published in the  Annals of Behavioral Medicine  found that of three groups assigned to journal for one month, the group asked to write about “cognitions and emotions related to a trauma or stressor” enjoyed the most benefits of writing therapy; they had a better perspective on the stressful experience about which they wrote. 6

Sometimes this practice is self-generated. The act of journaling has increased in popularity, especially with the growth of aesthetic practices such as bullet journaling, which combines a journal, calendar, and planner. 7

Photo by Brent Gorwin on Unsplash

There are several types of writing therapy, which generally fall into two categories: writing therapy conducted with the guidance of a mental health counselor and self-motivated writing therapy, the latter of which anyone can take up at their own pace.

A counselor or mental health professional might use writing therapy with clients who find it difficult to verbalize their thoughts or emotions. Narrative therapy, a form of writing therapy that clients and therapists can use together, is often helpful in this situation. 8   Narrative therapy involves the client and mental health professional “reauthoring” a traumatic or problematic story from the client’s life. 9  This method helps the client recontextualize their experience by removing the assumptions and context they have assigned to it to see it from a more objective perspective. 8

Another common format, which can be practiced with or without the guidance of a mental health professional, is called interactive journaling. It combines aspects of writing therapy and bibliotherapy. In interactive journaling, clients are provided with a journal prompt, or a starting point, which they then use to inform their writing. This method is especially effective in substance abuse treatment because it can educate patients and promote reflection and exploration of their experiences. It can also benefit students in the health care field because it can help them empathize with and understand their clients’ experiences. 1

Two other types of writing therapy are focused writing and songwriting. Focused writing incorporates worksheets that educate and guide clients, 10  and songwriting combines music therapy and writing therapy to provide clients with an avenue to reminisce and express their emotions. 11

Researchers have found that expressive, or therapeutic writing, can have numerous physical and psychological health benefits, some of which include: 1

• better immune function
• fewer doctor visits
• less stress
• improved grades in school
• reduced emotional and physical distress
• decreased depression symptoms
• lower blood pressure
• improved liver function
• fewer missed days of work
• strengthened memory

In addition to its general benefits, writing therapy has been an easily accessible resource to treat people with many different conditions and stressful or traumatic experiences.

Posttraumatic Stress Disorder

Evidence suggests that writing therapy can  posttraumatic stress disorder (PTSD)  symptoms and the symptoms of depression often associated with PTSD. The potential effectiveness of writing therapy in helping people cope with trauma makes it a useful alternative when more traditional modes of therapy are ineffective or impossible to access. 12

For example, a study published in 2013 in the  Journal of Sexual Medicine  used writing therapy to treat 70 women who had experienced childhood sexual abuse. Researchers asked the women to write about trauma or sexual schema (the “cognitive generalizations” someone has about their sexual selves, informed by prior sexual experiences) during five 30-minute sessions, which occurred over up to five weeks. 13  At three different intervals—two weeks, one month, and six months—the study participants were asked to complete interviews and questionnaires regarding their sexual function, PTSD, and depression. Researchers found that between pretreatment and posttreatment, participants reported fewer symptoms of PTSD. According to study findings, participants who wrote about sexual schema were also more likely to recover from sexual dysfunction. 14

Some studies have found that engaging in writing therapy can help reduce  anxiety . 15 , 16  In a study conducted in 2020 by faculty of Tabriz University of Medical Sciences in Iran, researchers administered three writing therapy sessions to pregnant women, plus two telephone calls between the sessions and basic pregnancy care, over four to six weeks. During the first session, the women were asked to write about their concerns regarding pregnancy and brainstorm solutions that would help relieve the anxiety they induce, and the phone calls encouraged them to follow through with the solutions. In the second session, researchers employed narrative therapy techniques and asked the women to write a story that outlined their concerns about pregnancy and then applied the solutions they had previously generated. The final session fostered a group discussion between the participants about the previous assignments. The study concluded that the women who engaged in writing therapy had significantly less anxiety than a comparison group who received only the standard pregnancy care. 17

Studies have shown that symptoms of depression decrease among people who utilize writing therapy. For example, in one study published in a 2014 issue of  Cognitive Therapy and Research , one group of undergraduate students was tasked with non-emotional writing, or writing that does not focus on difficult or traumatic experiences and feelings, and another group was tasked with expressive writing, writing that does deal with emotional distress and trauma, focused in this case on emotional  acceptance . The students in the latter group who experienced low or low to mild symptoms of depression saw a reduction in their symptoms. 18

Another study, conducted by researchers from the Catholic University of the Sacred Heart in Italy with women who had recently given birth, again divided participants into two groups; one performed expressive writing, and the other simply wrote about neutral topics. The women who used expressive writing had lessened depressive symptoms, whereas those in the neutral writing group saw no significant change. 19

Bereavement

People suffering the loss of a loved one can benefit greatly from writing therapy. It can reduce the number of negative feelings surrounding the event and allow for closure. It promotes self-care and therefore helps the client recover after a loss. 20  Writing therapy can also help reduce the  separation anxiety  that  grief  can prompt, gives clients a fresh perspective on their loss, and recognizes their bereavement journey. 21

A 2011 study published in the  Journal of Psychosomatic Obstetrics and Gynaecology  conducted 10 writing sessions over five weeks with people who had lost pregnancies. The participants were asked to write about their pregnancy loss, write a letter to a friend as if the friend were experiencing the same loss, and write a letter to themselves or to someone who witnessed the loss. The participants’ levels of grief and loss decreased after the writing therapy treatment. 22

Technology  has made many forms of therapy more accessible for many people. The internet can connect people in nearly any geographical zone to therapists who may be physically distant. Writing therapy, in particular, transitions easily to the virtual world; most forms don’t require face-to-face meetings at all and can be conducted over email.

In addition, writing therapy is a form of self-help intervention that anyone may practice. Many writing prompts (such as these links from  Disability Dame  and  Dancing through the Rain ) are available online and enable people to immediately begin writing and benefit from this therapy. 23  Whether practitioner- or self-guided, writing therapy is an accessible practice that offers many potential benefits to those who use it.

• Moy, J. D. (2017). Reading and writing one’s way to wellness: The history of bibliotherapy and scriptotherapy. In Higler, S. (Ed.), New Directions in Literature and Medicine Studies (pp. 15–30). Palgrave Macmillan. https://doi.org/10.1057/978-1-137-51988-7_2
• Holden, J. D., & Mugerwa, S. (2012). Writing therapy: A new tool for general practice? British Journal of General Practice, 62(605), 661–663. https://doi.org/10.3399/bjgp12X659457
• THC Editorial Team. (May 22, 2021). Reading as therapy: Bibliotherapy and mental wellness. The Human Condition. https://thehumancondition.com/reading-as-therapy-bibliotherapy/
• Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162–166. https://doi.org/10.1111/j.1467-9280.1997.tb00403.x
• Qian, J., Sun, S., Sun, X., Wu, M., Yu, X., & Zhou, X. (2020). Effects of expressive writing intervention for women’s PTSD, depression, anxiety, and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Research, 288. https://doi.org/10.1016/j.psychres.2020.112933
• Lutgendorf, S. K., & Ullrich, P. M. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expression. Annals of Behavioral Medicine, 24, 244–250. https://doi.org/10.1207/S15324796ABM2403_10
• Normark, M., & Tholander, J. (2020). Crafting personal information: Resistance, imperfection, and self-creation in bullet journaling. Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems, 1–13. https://doi.org/10.1145/3313831.3376410
• Goodrich, T., Hancock, E., Kitchens, S., & Ricks, L. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9, 99–110. https://doi.org/10.1080/15401383.2013.870947
• Madigan, S. (2011). Narrative therapy. American Psychological Association.
• McGihon, N. N. (1996). Writing as a therapeutic modality. Journal of Psychosocial Nursing & Mental Health Services, 34(6), 31–35. https://doi.org/10.3928/0279-3695-19960601-08
• Ahessy, B. (2017). Song writing with clients who have dementia: A case study. The Arts in Psychotherapy, 55, 23–31. https://doi.org/10.1016/j.aip.2017.03.002
• Kamphuis, J. H., Reijntjes, A., & van Emmerik, A. A. P. (2013). Writing therapy for posttraumatic stress: A meta-analysis. Psychotherapy and Psychosomatics, 82(2), 82–88.
• Anderson, B. L., & Cyranowski, J. M. (1994). Women’s sexual self-schema. Journal of Personality and Social Psychology, 67(6), 1079–1100. https://doi.org/10.1037/0022-3514.67.6.1079
• Lorenz, T. A., Meston, C. M., & Stephenson, K. R. (2013). Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: Results from a randomized clinical trial. The Journal of Sexual Medicine, 10(9), 2177–2189. https://doi.org/10.1111/jsm.12247
• Barrett, M. D., & Wolfer, T. A. (2001). Reducing anxiety through a structured writing intervention: A single-system evaluation. The Journal of Contemporary Social Services, 82(4), 355–362. https://doi.org/10.1606/1044-3894.179
• Shen, L., Yang, L., Zhang, J., & Zhang, M. (2018). Benefits of expressive writing in reducing test anxiety: A randomized controlled trial in Chinese samples. PLoS One, 13(2), Article e0191779. https://doi.org/10.1371/journal.pone.0191779
• Esmaeilpour, K., Golizadeh, S., Mirghafourvand, M., Mohammad-Alizadeh-Charandabi, S., & Montazeri, M. (2020). The effect of writing therapy on anxiety in pregnant women: A randomized controlled trial. Iranian Journal of Psychiatry and Behavioral Sciences, 14(2). https://doi.org/10.5812/ijpbs.98256
• Baum, E. S., & Rude, S. S. (2013). Acceptance-enhanced expressive writing prevents symptoms in participants with low initial depression. Cognitive Therapy and Research, 37. 35-42. https://doi.org/10.1007/s10608-012-9435-x
• Camisasca, E., Caravita, S. C. S., Di Blasio, P., Ionio, C., Milani, L., & Valtolina, G. G. (2015). The effects of expressive writing on postpartum depression and posttraumatic stress symptoms. Psychological Reports, 117(3), 856–882. https://doi.org/10.2466/02.13.PR0.117c29z3
• Kristjanson, L. J., Loh, R., Nikoletti, S., O’Connor, M., & Willcock, B. (2004). Writing therapy for the bereaved: Evaluation of an intervention. Journal of Palliative Medicine, 6(2), 195–204. https://doi.org/10.1089/109662103764978443
• Thatcher, C. (2021). Whys and what ifs: Writing and anxiety reduction in individuals bereaved by addiction. Journal of Creativity in Mental Health. https://doi.org/ 10.1080/15401383.2021.1924097
• Kersting, A., Kroker, K., Schlicht, S., & Wagner, B. (2011). Internet-based treatment after pregnancy loss: concept and case study. Journal of Psychosomatic Obstetrics and Gynaecology, 32(2), 72–78. http://doi.org/10.3109/0167482X.2011.553974
• Wright, J. (2002). Online counselling: Learning from writing therapy. British Journal of Guidance & Counselling, 30(3), 285–298. https://doi.org/10.1080/030698802100002326

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What Is Creative Writing Therapy

Table of Contents

What is creative writing therapy?

Creative writing therapy, or therapeutic writing is a form of therapeutic intervention that uses writing as the tool to explore and express your thoughts, feelings and emotions. It’s also known as journal therapy – and it’s essentially the art of writing in a journal to heal yourself.

How far could creative writing act as therapy?

Whatever the format, writing therapy can help the individual propel their personal growth, practice creative expression, and feel a sense of empowerment and control over their life (Adams, n.d.). It’s easy to see the potential of therapeutic writing.

What is creative writing training?

Studying creative writing will help you enhance your general linguistic skills and hone your unique writing voice. You’ll learn new ways to express yourself clearly and creatively in various written forms. Those enhanced communication skills can be a powerful asset in the business world as well as your personal life.

What are the different types of writing therapy?

It may be supervised by a mental health professional or even occur with little or no direct influence from a counselor. There are several types of writing therapy, including, but not limited to narrative therapy, interactive journaling, focused writing, and songwriting.

What is an example of writing therapy?

Compose a letter. Imagine this person has written to you and asked you: “How are you doing, really?” Another exercise is to “write to someone with whom you have ‘unfinished business’ without sending it.” The goal is for you to gain a clearer understanding of your own thoughts and feelings about the person, she said.

What is an example of creative therapy?

Creative therapy uses art forms — such as dance, drawing, or music — to help treat certain conditions. Trained therapists can administer creative therapy to help people experiencing a range of mental, emotional, and physical issues. Creative therapy does not require a person to have any sort of artistic ability.

What is the purpose of writing therapy?

Writing therapy is a form of expressive therapy that uses the act of writing and processing the written word for therapeutic purposes. Writing therapy posits that writing one’s feelings gradually eases feelings of emotional trauma.

How do you start therapeutic writing?

• Create a routine of your journaling habits. Many people begin journaling with the best intentions, but find that the habit is difficult to establish. …
• Find somewhere quiet to write. …
• Decide on the topic you want to explore. …
• Start writing! …
• Repeat. …
• Sources and references:

Is creative writing good for your brain?

CREATIVE WRITING STRENGTHENS OUR MEMORY: It can help contextualise ideas and make them more manageable in our brains. The written word can be more trustworthy than our own thinking. Even a small note on a piece of paper might spark our recollection of an unfinished task.

What are the 4 types of creative writing?

The primary four forms of creative writing are fiction, non-fiction, poetry, and screenwriting. Writers will use a mixture of creative elements and techniques to tell a story or evoke feelings in the reader. The main elements used include: Character development.

Can I teach myself creative writing?

Many beginners can feel intimidated or embarrassed by their creative work and where their imagination takes them. Through freewriting, creative writing exercises, writing prompts, and practice, you can improve your own writing skills to become a better writer.

What skill is creative writing?

Creative writing is an art. And like everything artistic, it requires imagination. Whether it is a poem, story, blog, or any other form of writing, the writer must use imagination and expression to evoke emotion from the readers.

Who created writing therapy?

James Pennebaker was the first researcher that studied therapeutic effects of writing. He developed a method called expressive writing, which consists of putting feelings and thoughts into written words in order to cope with traumatic events or situations that yield distress (Pennebaker & Chung, 2007).

What kind of writing do therapists do?

Most of those I spoke to said they jot down information about symptoms, demographics, treatment history, and personal history during that first meeting so as to get a sense of both what potential issues they’ll be tackling and who the patient is more generally.

What are the 6 writing techniques?

The Six Traits of writing are Voice, Ideas, Presentation, Conventions, Organization, Word Choice, and Sentence Fluency. It creates a common vocabulary and guidelines for teachers to use with students so that they become familiar with the terms used in writing. It develops consistency from grade level to grade level.

What are the benefits of creative writing in therapy?

CREATIVE WRITING HELPS YOU TO EXPRESS YOUR FEELINGS: Some may also use creative writing as a way of connecting with others. Sharing tales and perspectives while also learning from, and supporting one another. Writing about difficult situations can help us release our feelings in a healthy way.

What is creative writing and examples?

What is an example of creative writing? One example of creative writing is fiction writing. Fiction includes traditional novels, short stories, and graphic novels. By definition, fiction is a story that is not true, although it can be realistic and include real places and facts.

What is creative writing in simple terms?

Creative writing, a form of artistic expression, draws on the imagination to convey meaning through the use of imagery, narrative, and drama. This is in contrast to analytic or pragmatic forms of writing. This genre includes poetry, fiction (novels, short stories), scripts, screenplays, and creative non-fiction.

What is creative arts therapy used for?

Creative arts therapy is a profession that uses active engagement in the arts to address mental, emotional, developmental, and behavioral disorders. Creative arts therapy uses the relationship between the patient and therapist in the context of the artistic process as a dynamic force for change.

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Nyssen OP, Taylor SJC, Wong G, et al. Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations. Southampton (UK): NIHR Journals Library; 2016 Apr. (Health Technology Assessment, No. 20.27.)

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations.

Chapter 1 background.

• Therapeutic writing

Writing as a form of therapy to improve physical or mental health has a long history 1 and is widely reported in psychology textbooks as being of therapeutic value. 2 – 5 It can take many formats including those from a psychotherapeutic background, such as therapeutic letter writing, 6 specific controlled interventions, such as emotional disclosure/expressive writing, 7 to more recent approaches, such as developmental creative writing 8 and other epistolary approaches, such as blogging. 8 With the development of UK organisations such as Lapidus (Association for Literary Arts in Personal Development), dedicated to the promotion of therapeutic writing (TW) based on the premise that it has health benefits, and an increased interest in the potential of non-pharmacological adjunctive therapies, it is important to evaluate the effectiveness of a variety of different approaches within this field. These include two main categories: written emotional disclosure [or emotional writing (EW)] 9 and creative writing, such as poetry. 7 Other forms of creative writing include alpha writes/poems (a poetic device in which each successive line of the poem starts with the next letter of the alphabet, or a predetermined word or phrase written vertically down the page); 10 writing from published poems/narratives; acrostics; and haiku poems (traditionally a haiku contains three lines of five, seven and then five syllables, making a total of 17 syllables; the tradition is modified so that no more than 17 syllables are arranged in no more than three lines, but the shorter the better); 11 autobiographical writing (such as reflective diaries, journaling); descriptive writing; genre writing (e.g. fairy tales); free writing; short stories; drama or fictional narratives; unsent letters; diary/journaling; collaborative writing (workshops); writing accompanying other art forms; life writing or memoirs (such as reminiscence, life review); list writing; redrafting or sentence stems writing; scribing for others; writing from visual/sound stimuli (e.g. writing from mindfulness); writing from the senses; and writing in form and writing from music (as part of a music therapy). 10 , 12 Newer forms of writing include blogging or participating in web-based forums. 13 , 14

• Dimensions of therapeutic writing

Within each type of TW there may be significant process variability, for example in the flexibility and number of topics; the dose (frequency and duration); group or individual delivery; computerised compared with handwritten exercises; participant recruitment; and financial compensation. However, a major distinction lies in whether the writing is facilitated or unfacilitated.

Facilitated therapeutic writing

Facilitated TW interventions, when a facilitator is present at some stage before or during the writing, might be delivered in many different ways and contexts: in a health-care centre, as part of a programme in a rehabilitation clinic or within a group of people with common or different chronic conditions, face to face or via the internet. People using these therapeutic tools may receive feedback from someone else, a health-care professional, a group of persons or not receive feedback at all. 10

Furthermore, the topic of the writing can be varied, from positive to negative expression of emotions through neutral topics (e.g. childhood/birth, life aims and goals, places, relationships). 10 TW can also be used in children, adolescents or adults and among different clients, such as the chronically ill (e.g. cancer, mental health problems, chronic infections) or healthy individuals, and assessed from different angles such as community carers, doctors and nurses, peer training, patient’s family and/or friends or the participant him/herself – the most usual perspective. 10

The writing event should not be considered as solely an isolated exercise but as a sequence of exercises, not necessarily all of which encompass a written component. As such, a common practice is that writing starts with (visual) stimuli 12 or with mindfulness meditation in order to inspire people and to act as a form of distraction from reality. 15 The following examples of the work of facilitated writing practitioners in the UK exemplify the variety of this type of TW ( Box 1 ).

Examples of facilitated therapeutic writing Writing practitioner Carol Ross (CR) facilitates weekly TW groups for inpatients in mental health units in a UK NHS Foundation Trust. CR has developed her own practice, influenced by a number of published research (more...)

Perhaps the last thing to add is that clinicians at Freedom from Torture continue to send more clients than can be coped with, which is some vindication of the practice. As a bridge between intense therapy and the outside world, giving clients a skill they can take with them and a means of self-discovery, self-healing and personal growth, it seems, as the Hippocratic Oath puts it, to do no harm, and a great deal of good.

Unfacilitated emotional writing

Unfacilitated EW means writing, completed without any assistance, feedback, comment or any other form of support. Therefore, in the current review, an unfacilitated writing intervention has been defined as when a facilitator was simply not present in person during the writing exercise, as opposed to facilitated writing (described above). Typically, in unfacilitated writing interventions, participants are instructed to write for 15–30 minutes on 3 to 4 consecutive days (or at weekly intervals). Instructions on these unfacilitated writing assignments can be delivered in writing via leaflets, verbally over the telephone or even via video or the internet. Participants are asked to do their writing unassisted and alone at home or on their own in a given clinic or laboratory setting. In the most commonly evaluated form of unfacilitated EW, there is a single writing topic that can be chosen (usually disease or treatment focused), for which participants are directed to write emotionally and disclose about their deepest thoughts and feelings or about a self-selected trauma. Thereafter, either the writings may be collected by the practitioner without any feedback or the participant can simply decide what to do with the writing. Sometimes, practitioners provide participants the option to make telephone calls during the writing exercise should any concerns emerge; however, this action has not been considered as facilitation in this review.

The Pennebaker writing paradigm: expressive writing or written emotional disclosure

This is the most common form of unfacilitated EW. It is a technique whereby people are encouraged to write (or talk into a tape recorder) in private about a traumatic, stressful or upsetting event, usually from their recent or distant past. They write for 15–30 minutes typically for 3 or 4 days within a relatively short period of time, such as on consecutive days or within 2 weeks. The format has been relatively consistent since the earliest randomised controlled trials (RCTs), 1 , 18 but more recent studies have varied the duration, number of sessions and topic of writing, including positive events and thoughts and feelings about illnesses. 19 RCTs of expressive/emotional writing have been conducted in a wide variety of participants, including healthy students, people undergoing psychological stressors, such as bereavement or being in a caregiving role, or in people with long-term physical conditions, such as rheumatoid arthritis (RA) and asthma. Variants of the technique include disclosure in front of a listener, who can be a confederate, a researcher or a doctor. For the purposes of this project, these activities are not considered to be EW and lie outside the scope of this review. The presence of a listener is likely to affect outcomes, as it potentially adds a counselling dimension.

Positive writing

Positive writing can be delivered either as part of a facilitated TW or unfacilitated EW intervention. The exercise involves writing about positive topics only, including positive emotions, typically for 20–30 minutes, three or four times per week if delivered as an unfacilitated EW intervention. Otherwise, the duration and length of the positive writing can be very varied when facilitated (see Appendix 1 ). Pennebaker et al. 19 found in a review published in 1997 that the description of positive emotions could predict improvements in health outcomes. Since then, researchers have studied the positive effects of the positive emotional disclosure, advocating that participants writing about the positive aspects of past traumas (benefit finding by describing any positive outcomes of the disease experience or treatment in detail) or simply about positive life events, could achieve comparable health improvements as those writing about past traumas. 20

Bibliotherapy

Although the above require the individual to write as part of therapy, other forms of therapy use existing texts. The most commonly encountered type of bibliotherapy, Reading Bibliotherapy, involves reading material specifically selected for its therapeutic potential for that person. 21 In the UK, Books on Prescription Schemes have been running in primary care for several years, and in 2013 a national scheme was launched in England by the Society of Chief Librarians and the Reading Agency. 22 Such reading bibliotherapy is not covered by this review.

In contrast, interactive bibliotherapy has been defined as the use of literature to bring about a therapeutic interaction between participant and facilitator. 21 The triad of participant, literature and therapist is viewed as critical. In fact, interactive bibliotherapy does not restrict itself to the written word: it can include the spoken word, for example in film or theatre but it must involve the coherent use of language. When interactive bibliotherapy uses poetry, it is synonymous with poetry therapy and they are both encompassed by the term biblio/poetry therapy. 21 Sometimes the literature involved in biblio/poetry therapy is new writing generated by the participants themselves. This type of creative writing biblio/poetry therapy is the principal form of facilitated TW included in this review and it is the form of TW used by the practitioner experts collaborating in the current systematic reviews (see Box 1 , in which the TW expert practitioners describe their different facilitated biblio/poetry therapy practices).

Nonetheless, little has been published around all the different types of facilitated TW, and literature shows that the most evaluated form of TW is the EW intervention, described by Pennebaker and Beall 1 Comprehensive research around the writing paradigm 18 , 23 – 27 and narrative analysis within the health-care setting 28 – 31 has been performed through the last decades.

• Long-term conditions

The prevalence of long-term conditions (LTCs) increases with ageing populations. In 2002, the leading chronic diseases [cardiovascular disease (CVD), cancer, chronic respiratory disease and diabetes] were responsible for 29 million deaths worldwide. 32 According to the UK Department of Health (DH), 33 more than 15 million people in England (including half of all those aged > 60 years) are living with at least one LTC, and the risk of death is particularly high in those with three or more conditions occurring concurrently. 34 LTCs also result in a huge burden on UK NHS resources. Although some are preventable, for most LTCs the only realistic management strategy is continuing care, as biological and psychosocial mechanisms regulating disease progression are not yet fully understood. As LTCs are difficult to improve, especially for elderly populations, health-care programmes, such as self-management support and patient education, often combined with structured clinical follow-up, have been suggested as a way to improve the quality of life (QoL) of such patients. 35 New therapeutic approaches, such as TW, have the potential to improve the QoL in people with LTCs.

• Possible pathways linking memory, emotions and physical health

There are several potential ways that writing might impact on physical health. For example, cognitive restructuring or behavioural mechanisms (e.g. reflection on health behaviours) may lead to improvement in outcomes. However, many of the types of TW described above engage emotions and memories (both positive or negative) and there are physiological pathways linking memory, emotions, chronic stress and physical health.

Two interdependent memory systems are thought to be associated with remembering events in humans. 36 Episodic memory is linked to the hippocampus and this structure is vital for processing events that eventually become long-term memories. 37 Emotional memory is linked to the amygdala, part of the limbic system involved with emotions, in particular fear-related responses and general pleasant and unpleasant emotional processing. 38 Although the episodic and emotional memory systems are independent, they affect each other in a variety of ways. 36 Emotion enhances perception of, and attention to, the memory-provoking stimulus, as well as the long-term storage of the memory. 36 Episodic memory also influences emotional memory by, for example, causing the autonomic effects of emotional arousal (e.g. the sweaty palms and dry mouth) when remembering a past situation. 36

The limbic system has links with the cerebral cortex, the brainstem and the pituitary gland (part of the hypothalamic–pituitary–adrenal axis). Parts of the cerebral cortex have a role in cognitive appraisal and the conscious awareness of emotional states, and can regulate amygdalar activity. 38 Through the brainstem, areas in the limbic system can control many internal conditions of the body, for example cardiovascular regulation. The hypothalamic–pituitary–adrenal axis is both responsive to psychological inputs and has significant influences on the immune system, which, in turn, influences physical health. 39 This pathway may be one of the ways chronic stress is linked to poor health. 39 – 42 It is therefore possible that a psychological intervention might improve aspects of physical health, and if modification of such pathways had even a small effect then this could have profound public health significance.

• Realist synthesis

In this review, a conventional systematic review of the effectiveness of unfacilitated EW and facilitated TW was conducted, but, in addition, the findings of a realist synthesis are reported. Realist synthesis is a theory-driven interpretive approach to evidence synthesis. Rather than producing a judgement on whether (or not) an intervention works, realist syntheses attempt to explain outcome patterns in data using theory (or theories). It is particularly useful when interventions are complex and evidence is mixed or conflicting and provides little or no clues as to why the intervention worked or did not work when used in different contexts, by different stakeholders or when used for different purposes. 43

In brief, realist syntheses ask what works for whom in what circumstances, how and why? To do so, realist syntheses use a particular logic of analysis that deliberately breaks down how an outcome has arisen. An outcome is considered to have occurred because it is caused to do so by a causal process known as a mechanism. In addition, the contexts in which an outcome has occurred are also considered to be important as they cause mechanisms to be activated. This logic of analysis thus provides an approach for understanding how and why it is that context can influence outcomes. In summary, the realist logic of analysis used in a realist synthesis considers the interaction between context, mechanism and outcome (sometimes abbreviated as CMO). That is how particular contexts have triggered (or, conversely, interfered with) mechanisms to generate the observed outcomes. 43

To elaborate further, in order to understand how outcomes are generated, the roles of both external reality and human understanding and response need to be incorporated. Realism does this through the concept of mechanisms, whose precise definition is contested but for which a working definition is ‘. . . underlying entities, processes, or structures which operate in particular contexts to generate outcomes of interest.’ 44 Different contexts interact with different mechanisms to make particular outcomes more or less likely – hence, in general, a realist synthesis produces recommendations of the general format ‘In situations [X], complex intervention [Y], modified in this way and taking account of these contingencies, may be appropriate’. This approach, when done well, is widely recognised as a robust set of methods, which is particularly appropriate when seeking to explore the interaction between CMO in a complex intervention [e.g. see Berwick’s editorial explaining why experimental (RCT/meta-analysis) designs may need to be supplemented (or perhaps in some circumstances replaced) by realist studies aimed at elucidating CMOs]. 45

The philosophical basis underpinning a realist synthesis is realism. Realism assumes the existence of an external reality (a real world) but one that is filtered (i.e. perceived, interpreted and responded to) through human senses, volitions, language and culture. Such human processing initiates a constant process of self-generated change in all social institutions, a vital process that has to be accommodated in evaluating social programmes. In other words, the way individuals interpret and respond (or not) to the world around them has the potential to cause changes to this world around them. Such changes may then cause additional responses from individuals, potentially leading to a series of feedback loops. Within a realist synthesis, where possible, attempts are made to understand these feedback loops.

A realist approach is particularly useful for this project because TW is a complex intervention that could be useful in a variety of patient groups, and currently it is unclear whether it is effective for all or some, and how and why it might be effective.

Realist syntheses often use input from content experts to help develop the programme theories needed to explain how complex interventions work. In this project, input from practitioner experts was deliberately sought. During the second programme theory-building meeting with practitioner experts, they were asked for their feedback on what their views were on how TW was meant to work, for whom and why (see Chapter 5 , Methods , for more details). Two practitioner experts [Carole Ross (CR) and Victoria Field (VF)] provided written responses (see Appendix 1 , Tables 76 and 77 , respectively) and have been included in this report as they provide an insight into how facilitated TW is used in the NHS and voluntary sector.

• Previous systematic reviews on therapeutic writing in long-term conditions

There have been a number of systematic reviews on expressive writing, 18 , 23 , 46 , 47 published in psychology journals, that have conducted meta-analyses according to normal practice in psychology, combining different types of participants and outcomes across different conditions, and using Cohen’s d or Hedges’ g statistics. Their results are difficult to interpret because effect sizes for specific populations and interventions are unclear. There have been three recent systematic reviews on TW in LTCs. One concerned post-traumatic stress disorder (PTSD) only and included five studies. 27 One of the included studies is on cognitive–behavioural therapy (CBT) rather than TW, 48 and another 49 is a very small, non-randomised study with students. A second, unpublished systematic review was accessed via the internet. 26 This assessed TW for psychological morbidity in people with long-term physical conditions. The review included 14 RCTs and searches were conducted up to May 2011. It is unclear why this review did not include a number of potentially includable studies including Abel et al. 50 [human immunodeficiency virus (HIV)], Graham et al. 51 (chronic pain), Halpert et al. 52 [inflammatory bowel syndrome (irritable bowel syndrome, IBS)], Henry et al. 53 (breast cancer), Hughes 54 (breast cancer), Kraaij et al. 55 (HIV), Petrie et al. 56 (HIV), Stark 57 [fibromyalgia (FM)] and Theadom et al. 58 (asthma), as all of these studies measure psychological morbidity and were published before the search end date. It may be that they did not include some of these because of their definition of long-term physical conditions, as there is no uniform definition as yet. It is unclear how the results might have differed if some of these studies had been included. The third systematic review evaluated the impact of support on the effectiveness of written cognitive–behavioural self-help 59 and thus was not really focused on TW per se. It included 38 studies, none of which are included in this project.

• Hypotheses tested in the review (research questions)

Overall aims and objectives of this review

• What are the different types of TW that have been evaluated in comparative studies? What are their defining characteristics? How are they delivered? What underlying theories have been proposed for their effect(s)?
• What is the clinical effectiveness of the different types of TW for LTCs compared with no writing or other suitable comparators?
• How is heterogeneity in results of empirical studies accounted for in terms of patient and/or contextual factors, and what are the potential mechanisms responsible for the success, failure or partial success of interventions (i.e. what works for whom in what circumstances and why)?
• What is the cost-effectiveness or cost–consequences of one or more types of TW, in one or more representative LTCs, when there is sufficient information on the intervention, comparator and outcomes to conduct an economic evaluation?

Included under terms of UK Non-commercial Government License .

• Cite this Page Nyssen OP, Taylor SJC, Wong G, et al. Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations. Southampton (UK): NIHR Journals Library; 2016 Apr. (Health Technology Assessment, No. 20.27.) Chapter 1, Background.
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Cover Story

Writing to heal

By helping people manage and learn from negative experiences, writing strengthens their immune systems as well as their minds.

By BRIDGET MURRAY

Monitor Staff

June 2002, Vol 33, No. 6

Print version: page 54

Writing is no stranger to therapy. For years, practitioners have used logs, questionnaires, journals and other writing forms to help people heal from stresses and traumas.

Now, new research suggests expressive writing may also offer physical benefits to people battling terminal or life-threatening diseases. Studies by those in the forefront of this research--psychologists James Pennebaker, PhD, of the University of Texas at Austin, and Joshua Smyth, PhD, of Syracuse University--suggest that writing about emotions and stress can boost immune functioning in patients with such illnesses as HIV/AIDS, asthma and arthritis.

Skeptics argue that other factors, such as changes in social support, or simply time, could instead be the real health aids. But an intensive research review by Smyth, published in 1998 in the Journal of Consulting and Clinical Psychology (Vol. 66, No. 1), suggests that writing does make a difference, though the degree of difference depends on the population being studied and the form that writing takes.

Researchers are only beginning to get at how and why writing may benefit the immune system, and why some people appear to benefit more than others. There is emerging agreement, however, that the key to writing's effectiveness is in the way people use it to interpret their experiences, right down to the words they choose. Venting emotions alone--whether through writing or talking--is not enough to relieve stress, and thereby improve health, Smyth emphasizes. To tap writing's healing power, people must use it to better understand and learn from their emotions, he says.

In all likelihood, the enlightenment that can occur through such writing compares with the benefits of verbal guided exploration in psychodynamic psychotherapies, notes Pennebaker. He notes, for example, that talking into a tape recorder has also shown positive health effects. The curative mechanism appears to be relief of the stress that exacerbates disease, researchers believe.

Health benefits

A groundbreaking study of writing's physical effects appeared in the Journal of the American Medical Association (Vol. 281, No. 14) three years ago. In the study, led by Smyth, 107 asthma and rheumatoid arthritis patients wrote for 20 minutes on each of three consecutive days--71 of them about the most stressful event of their lives and the rest about the emotionally neutral subject of their daily plans.

Four months after the writing exercise, 70 patients in the stressful-writing group showed improvement on objective, clinical evaluations compared with 37 of the control patients. In addition, those who wrote about stress improved more, and deteriorated less, than controls for both diseases. "So writing helped patients get better, and also kept them from getting worse," says Smyth.

In a more recent study, presented in a conference paper and submitted for publication, Pennebaker, Keith Petrie, PhD, and others at the University of Auckland in New Zealand found a similar pattern among HIV/AIDS patients. The researchers asked 37 patients in four 30-minute sessions to write about negative life experiences or about their daily schedules. Afterward, patients who wrote about life experiences measured higher on CD4 lymphocyte counts--a gauge of immune functioning--than did controls, though the boost to CD4 lymphocytes had disappeared three months later.

Regardless, the fact that they at first showed improved immune functioning suggests that it reduced their stress through a release of HIV-related anxiety, says Pennebaker. "By writing, you put some structure and organization to those anxious feelings," he explains. "It helps you to get past them."

Other research by Pennebaker indicates that suppressing negative, trauma-related thoughts compromises immune functioning, and that those who write visit the doctor less often. Also, Petrie's colleague Roger Booth, PhD, has linked writing with a stronger antibody response to the Hepatitis B vaccine.

Writing right

Not everyone agrees, though, that the mere act of writing is necessarily beneficial. In fact, initial writing about trauma triggers distress and physical and emotional arousal, researchers have found. And not all people will work through that distress therapeutically or through continued writing, says psychologist Helen Marlo, PhD, of Notre Dame de Namur University and a private practitioner in Burlingame, Calif. In past research, she found that, contrary to Pennebaker's results, writing about negative and positive life events produced no physical health benefits in undergraduate students.

"I get concerned that if people just write about traumatic events, they get raw and opened up and aren't able to work through it on their own," says Marlo. Her study did not, however, provide evidence that writing poses any long-term risk to people.

But there is evidence that the nature of a person's writing is key to its health effects, notes health psychology researcher Susan Lutgendorf, PhD, of the University of Iowa. An intensive journaling study (in press, Annals of Behavioral Medicine ) she conducted recently with her doctoral student Phil Ullrich suggests that people who relive upsetting events without focusing on meaning report poorer health than those who derive meaning from the writing. They even fare worse than people who write about neutral events. Also, those who focus on meaning develop greater awareness of positive aspects of a stressful event.

"You need focused thought as well as emotions," says Lutgendorf. "An individual needs to find meaning in a traumatic memory as well as to feel the related emotions to reap positive benefits from the writing exercise."

In explaining this phenomenon, Pennebaker draws a parallel with therapy. "People who talk about things over and over in the same ways aren't getting any better," he says. "There has to be growth or change in the way they view their experiences."

Evidence of a changed perspective can be found in the language people use, Pennebaker has found. For example, the more they use such cause-and-effect words as "because," "realize" and "understand," the more they appear to benefit.

Pennebaker also acknowledges that some personality types likely respond better to writing than others. Tentative evidence suggests that more reticent people benefit most. A host of other individual differences--including handling of stress, ability to self-regulate and interpersonal relations--also mediate writing's effectiveness.

A place in practice?

After all, writing's power to heal lies not in pen and paper, but in the mind of the writer, say a number of psychologists who use it with their patients. That's where clinicians come in, helping clients tap that healing power, they say. Private practitioner Marlo, for example, employs writing cautiously--using it only with patients who take to it, and closely integrating it into the therapeutic process.

"The cornerstone of therapy is engagement in the therapeutic relationship that addresses the individual's process--especially the intrapersonal, interpersonal, affective and symbolic dimensions of experience," says Marlo.

Another practitioner, Judith Ruskay Rabinor, PhD, author of "A Starving Madness: Tales of Hunger, Hope and Healing in Psychotherapy" (Gurze Books, 2002), has her patients explore their anxieties in writings between sessions, e-mailing her as the anxiety strikes them. Rabinor offers feedback on their writing and helps them track progress in their thinking.

Though more studies are needed, many behavioral researchers believe such approaches could also work with treating chronically ill people. "Writing is another potential tool in the armatorium of the clinical professional," says Smyth.

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On the Uncertain Border Between Writing and Therapy

Veronica esposito explores the intersection of creativity and trauma.

Years ago, I entered the world of mental health by getting myself a therapist. Little did I know that this small but decisive step would lead me deeper and deeper into the world of mental health, until I eventually found myself practicing therapy.

Every now and then I take a moment to look back on things, and I’m always kind of amazed: the changes the mental health world has made on me have been so great that it’s hard to imagine how the person I am today can actually occupy the same timeline as that of my pre-therapy self.

On a micro level, therapy has changed the very texture of the language that I use to speak and think my way through life; and on a macro level, it has transformed the basics of how I conceptualize myself and my world. To put it into literary terms, it’s a little like I switched the genre of my life—from say the claustrophobic modernism of a Franz Kafka to the truth-seeking comedy of a Lorrie Moore.

Going from Franz Kafka to Lorrie Moore is a pretty stunning change, and I think it shows the depth of what therapy can achieve. At its deepest, therapy seeks to make foundational change in who a person is. The various philosophies, approaches, techniques, laws, and ethics that collectively form the knowledge that therapy means to offer to the world is, at root, an attempt to imagine nothing less than how to live a good life and be a good person.

I’ve often reflected that such a transformative experience as that which I’ve had in the world of mental health must have made a sizable impact on who I am as a writer—and, in fact, many people have told me that they have seen the difference. I absolutely believe it’s there. Not just in how my writing looks and feels but in the very basis of what animates me to write, and basic assumptions I bring to my writing practice, how I envision and pursue the whole venture. My experiences have filled me with an interest in knowing exactly what therapy does for a writer’s work, which is why I set out to create this essay.

In researching this piece, I found something interesting: many creative writers and scientific researchers have explored the question of how creative writing may or may not be therapy, but I could not find anyone who had posed the question in the other direction: what impact therapy may have on one’s creative writing.

The research that I found on the matter tended—as research does—to focus on what effects specific applications of creative writing had on various mental health outcomes, like depression, dysfunction, and quality of life. There was an emphasis on trauma-processing and exploration, and the verdict was clear: writing can be an effective therapeutic tool.

By contrast, many of the creative writers who I read on the matter were much more leery of the prospect of writing being therapy. This is epitomized by memorist T Kira Madden’s Literary Hub essay “Against Catharsis: Writing is Not Therapy,” the jist of which states that artistic writing is much too prosaic and difficult to involve the “bleeding into the typewriter” that she equates with true “healing.” That is, when you’re laboring over every last word, there’s no room for catharsis—the very craftiness of creative labor precludes it, with Madden styling her writing self as just an actor working to create a product for an audience.

There were other voices, like that of Tara DaPra in Creative Nonfiction , who saw the writing process as more emotionally engaged and thus more therapeutic. In her essay “Writing Memoir and Writing for Therapy” she argues that “writing emotionally driven memoir is, in fact, cathartic, at least initially.” She see hammering out that messy first draft as akin to what one does in a therapy room, and she offers that this drafting can have further therapeutic benefits: you can let that draft sit for a while and return to your problems with fresh eyes, or the braver can show it to their friends and ask for input. In contrast to Madden’s boring workmanship, DaPra sees the writing process as driven by “emotion and instinct.”

Whether or not a writer was pro or con regarding creative writing being therapeutic, they tended toward an overly simplistic equation of therapy with the raw emotionality of catharsis. Certainly, therapy can provide individuals with space to fall to pieces and gush in a way that most daren’t do with friends, family, or partners, but it is much more than that. On its deepest and most powerful level, therapy attempts to change the basic assumptions and beliefs that one operates with as a human being: the story you tell yourself about who you are and what kind of a world you live in.

This is the most powerful kind of trauma-processing: to ask your brain to let go of the lessons that trauma has taught you and to instead believe in something different. Not all clients, of course, will reach that stage—for many, therapy may just be a space for emotional catharsis, working out day-to-day questions, and attaining better coping mechanisms—and that of course is fine and can still offer substantial benefit.

But I do think that, for writers, the opportunity to drill down to the most deeply held beliefs about who we are and what world we live in offers an amazing chance to examine the very stuff of one’s writing and to transform a writing practice. It is authors who had precisely these sorts of experiences in therapy whom I turn toward now.

Writer Isle McElroy, author of The Atmospherians , initially struck a note similar to Madden and DaPra, beginning our conversation by telling me that therapy has let them better “engage with traumatic events because I can see them differently because of the processing that I’ve done. It’s a thing that I can carry, not a thing that I have stepped inside of.” In our conversation, McElroy noted that they had to get through stages of processing their trauma; in these initial stages their writing tended to come out more like a journal-y first draft than a polished essay—therapy helped them do that work and move on to a different sort of writing.

Accordingly, McElroy explained that subsequent experiences in therapy went beyond just finding it useful as a tool for catharsis. They told me that therapy has helped them “connect with my curiosity. I’m being asked to have curiosity about myself that I didn’t previously. It’s the curiosity of discovery. Once I’ve become more settled, having an opportunity to explore has been really good. It drives me deeper into my own understanding of myself.” They added that “the relationship puts the onus on me, which has been especially helpful for the writing process. I’m digging deeper toward my actual thoughts.”

Ultimately, therapy lead McElroy to re-conceptualize the very purpose and goal of their writing: “a lot of the therapeutic process was finding self-worth outside of the entertainment that I can give to people. Previously my writing had been a desire to entertain others by revealing my own personal pain.”

McElroy’s remarks resemble my own experience of therapy and my aims as a therapist. Whereas the initial stages of therapy often involve lots of catharsis—letting go of all this painful emotional stuff that you’ve been holding on to—it usually moves on to a less emotionally flooded opportunity to re-envision yourself.

I very much relate to that deeper understanding of self that McElroy mentioned; for me personally, in drilling past the layers of trauma, I was able to see how so much of my relationship with the world was a product of that trauma mindset. I got down to a deeper stratum of self that felt more authentically me, and that I more and more let loose on the page. I also discovered, as McElroy mentioned, ways to be curious about myself, to in fact adopt curiosity as a stance.

I found my conversation with poet Kim Koga very stimulating in that she opened new ways for me to understand therapy itself as a creative process. Koga shared her experiences with EMDR—an acronym that stands for eye movement desensitization and reprocessing, an increasingly popular method for processing heavy trauma—telling me that EMDR felt like a creative process for her. “I like EMDR because it’s very experiential and creative,” she told me. “I use a lot of my creativity in my healing.” I liked Koga’s remarks because they troubled Madden’s binary of catharsis versus creativity: for Koga, catharsis itself involved using her creativity.

Koga was kind enough to share some of her experiences with EMDR with me, discussing it in terms very different from what many would consider therapy: she told me about magnificent, dreamlike journeys through her mind’s eye that she undertakes in the trance-like state created by EMDR. Part of Koga’s purpose in taking these inner journeys is to “make safe spaces inside my body and brain, where me and my child self can go. I put a door on it, where I can go when I need to.”

That is, when Koga has used therapy to build safe refuges where she can ride out the storm when she feels the trauma of past experiences manifesting in her brain and body. This process involves creativity that Koga has found transferable to her work as a poet.

In our conversation Koga also spoke of therapy in the more familiar terms of helping her get past creative blocks. “There’s a part of me that feels like I can’t stop writing the same poem that I’ve been writing since I was 20. I feel like so much of my poetry has been around trauma, death sex, violence. Therapy really helped me get unstuck. It’s helped me become more aware of things that I’m feeling, to move out of trauma in a way that can open my brain up more creatively.”

Koga also talked about therapy in terms of opening up her sensitivity: she shared how, before therapy, she used to be able to watch the extremely violent drama The Wire and not feel anything, but now she is so emotionally attuned that she finds it difficult to get through an episode.

Much of what Koga shared with me resonated with my own journey through therapy. Like Koga, it helped me to realign my sense of purpose and values so that I became interested in writing about different things than the trauma that had formerly drawn my writerly attention with a laser-focus.

Also like Koga, I found my senses opening back up, letting me connect with the world more thoroughly—this reconnection has had profound impacts on how I write. And even though I have not, like Koga, undertaken surreal journeys via EMDR, I have found that a lot of the creativity I’m pushed to use in therapy has also found applications in my writing process.

In writing this essay, I’ve come to see what a big, big topic this is, and I want to conclude here by stating my belief that this is a much larger story than I can hope to tell right here. Any sort of conclusion I can make right now is going to feel a little like a Band Aid. But, hoping to find somewhere to land for the time being, I’ll say the following: as writers, our inspiration and trauma often go hand in hand—they can often be difficult to distinguish, and they can feed off one another.

At this moment it feels right to hypothesize that my experiences in the world of mental health have left me better able to understand the inter-relationships between the two and to be in greater control of both. I’ll give the final word to Koga, whom I believe well embodies what I’m trying to say:

Post-therapy, the texture of my poems is now lighter and more introspective in an exploratory way, rather than focusing on the brutality that I felt. The textures have gotten more varied. It’s like when I walk into a fabric store and I can see everything, whereas I used to walk into a fabric store and feel like the black crepe was all there was. I feel like my poems are more nuanced than they used to be, and I’m more able to explore that darkness in a nuanced way.

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Narrative, life writing, and healing: the therapeutic functions of storytelling

• Published: 08 September 2018
• Volume 45 , pages 479–489, ( 2018 )

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Narrative therapy is a process of co-authoring life narratives that transforms literature into a practice which helps and heals clients. In a sense, the therapist serves as the client’s writing coach, equipping the client to work through his or her “problems” by means of life writing. Narrative therapy, emerging from a post-modern, social constructive background, constitutes a unique approach to personal healing, and life writing, as a meaning-constructing activity and the prototype of narrative therapy, has its therapeutic functions. The process of healing through life writing can take place in a classroom setting characterized by openness and empathy. I have witnessed such healing in my three years of research, and have discovered how the two-fold self—Self-1 and Self-2—co-author life narratives and foster healing. Self-1 acts as the main character as well as an involved narrator, while Self-2 acts as the narrator, listener, and counselor, and life narratives usually appear as a dialogue between these two selves. Self-1 and Self-2 merge when an epiphany occurs in the author’s writing that allows him or her to make sense of life experiences. Self-2 has different perspectives and resources that Self-1 lacks, and can re-narrate and assign new meanings to life experiences. Moreover, Self-2 deconstructs stereotypes and frees Self-1 from oppressive narratives by offering alternative life stories.

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Gu, Y. Narrative, life writing, and healing: the therapeutic functions of storytelling. Neohelicon 45 , 479–489 (2018). https://doi.org/10.1007/s11059-018-0459-4

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The Benefits and Drawbacks of Therapeutic Writing

Posted on 03.18.21 by Brittany Capozzi

Photo by Agence Olloweb on Unsplash

Therapeutic Writing

Princy Daniel’s recent article, “10 Questions to Ask Yourself When Journaling,” reminds me of how we may benefit from the use of therapeutic writing. Therapeutic writing, or “expressive” writing, asks us to focus on healing ourselves after trauma or abuse. One of the pioneers of therapeutic writing is psychologist James Pennebaker. Many of his exercises contribute to spiritual growth, but as with other healing tools, there are benefits and drawbacks depending on whether this technique is right for the individual.

3 Benefits of Therapeutic Writing

• It may contribute to finding compassion: One of the benefits of therapeutic writing is that it allows one to write in the point of view of someone else who was involved in the traumatic scene. In doing so, we may come to find a detail that helps us find compassion for that person who we may not be able to understand, or perhaps forgive.
• Negativity and fear may leave the mind: When people say “Get it out onto the page,” we can actually move the “past” past us and give it space elsewhere instead of allowing it to occupy our mind. Some people who have used writing for therapeutic purposes—regardless of the writing form such as poetry or a story chapter—have felt physically lighter once getting things out onto the page.
• It could tap into hidden courage: If one has yet to talk about something that’s happened, a piece of paper with only the writer’s presence can be comforting. There is no judgment or punishment, only empty space waiting for a voice. This can be an opportunity for tapping into courage to face what happened. Seeing the scene on a page could offer the person some distance that wasn’t there before, thus a first step toward healing.

3 Drawbacks of Therapeutic Writing

• It may re-traumatize: One of the most important drawbacks to be aware of is that writing a scene means to relive the scene. Reliving the scene may be reliving trauma or abuse. If the story hasn’t left the body, exercises can set off mental triggers. In the book, “In An Unspoken Voice,” psychologist Peter Levine talks about purposely shaking off his body after getting hit by a car. This shaking off can actually ground the nervous system and reset it.
• There may be too many pairs of “I’s:” If there are too many “I’s” in therapeutic writing, the ego may be taking over instead of the part of the brain that allows healing to happen. While getting creative or “righting” the wrong can turn into art or venting, staying humble and present is more important than taking the writing away from yourself (and possibly toward others for validation).
• It may veer from the goal of healing: Therapeutic writing is very close to journaling or venting on the page, but if we continuously write without ever reflecting on our visual voice across the page, we lose our direction toward healing.

How to Move Forward

If one isn’t sure if therapeutic writing is the right approach, one should check in with current emotions, breath, energy level, and trigger points. Sometimes therapeutic writing may be something that is better off trying after talk or movement therapy, as Levine explored.

Resources used:  

Levine, peter., (2010) in an unspoken voice, berkeley, ca north atlantic books., pennebaker, james., (1997) opening up, nyc. the guilford press, second edition..

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By Brittany Capozzi

Capozzi holds a BA in English from Curry College with a double concentration in Creative Writing and Professional Writing. While enrolled, she presented her undergraduate thesis, “Therapeutic Writing: A Remedy for Understanding and Transforming Life Experiences.” At Step Up For Mental Health she has been a Digital Content Writer, Peer Support Trainer, and HR Generalist. Capozzi is a 500-hour certified yoga instructor with a focus in Therapeutic Essentials and has taught Yin Yoga as well as Yoga for Depression and Anxiety.

Writing Memoir and Writing for Therapy

An inquiry on the functions of reflection.

A year and a half into my undergraduate studies, my boyfriend Matthew committed suicide, which threw a wrench into the straight line I’d envisioned my college life would follow. I transferred schools before dropping out and then floated around for a while. His was the first death I’d experienced, and it changed me irrevocably. Amid my grief, I puzzled over how removed Americans are from death and loss.

Eventually I resumed my studies, at the University of Minnesota, and enrolled in “Cinematics of Loss,” a film class offered by the English department. The professor had recently written a book about how she’d never properly grieved her father’s death—he had drowned when she was nine—until as an adult, she found herself sobbing at every film she attended. We watched Krzysztof Kieslowski’s Blue , Peter Weir’s Fearless , and Hirokazu Kore-eda’s Maborosi . I wrote a paper analyzing the ways in which Todd Field’s beautiful film In the Bedroom , based on Andre Dubus’s short story “Killings,” captures the differences between masculine and feminine grief.

One day, I approached the professor and said something clumsy like, “This is what I want to do with my life.” I didn’t know quite what this was, but I knew I wanted to be engaged with the human questions of loss and grief, to acknowledge them as an essential part of being. I wanted to write and think and talk about them. I thought, first, about psychotherapy and then, briefly, considered becoming a funeral director. (With the Baby Boomers rounding that metaphorical bend, there’d be no shortage of work.) “Have you considered creative nonfiction?” my professor asked. I had never heard of creative nonfiction as a literary form, though like many, I’d certainly read it and even written a bit.

On the first day of “Introduction to Literary Nonfiction,” the instructor, a graduate student, introduced herself and made an announcement: “This class is not therapy.” Afterward, I went to her office hours in a panic. “But I find writing very therapeutic,” I said. “Am I doing something wrong?”

She backtracked. “I do, too,” she said. “It’s just that last semester, I had students turning in diary entries about what jerks their boyfriends were.”

In making her announcement, my instructor was wrestling to separate reflection, that fundamental element of creative nonfiction, from the task of general psychological introspection. But I wondered: Is there a difference?

In her classic essay “Memory and Imagination,” Patricia Hampl writes:

Our capacity to move forward as developing beings rests on a healthy relationship with the past. Psychotherapy, that widespread method for promoting mental health, relies heavily on memory and on the ability to retrieve and organize images and events from the personal past. . . . If we learn not only to tell our stories but to listen to what our stories tell us—to write the first draft and then return for the second draft—we are doing the work of memory.

Hampl describes how psychotherapy mimics the writing process, but I wondered whether the reverse was also true: Could writing about pain and loss do the work of psychotherapy? And if so, could this writing be “literary,” or did it become something else, something lesser?

While there are clear parallels between reflecting in creative nonfiction and reflecting in our private lives, academia—like the larger culture—remains anxious about crossing into the land of therapy. Do writing teachers fear tissues littered across the floor, strangers breaking down? Or are we afraid of opening our own wounds? We’re trained to compartmentalize relationships and responsibilities, to be professionals. Writing is about writing. Want to be safe? Stick to nature, or call it fiction.

At other times, writing teachers struggle to draw the line between instruction and counseling. In another creative writing class I took, a classmate wrote about the death of her friend’s son, and the professor responded by recommending she read books about grief. The student became frustrated that she was focusing on the subject matter instead of the writing. But in that same class, another student seemed to want more than a literary critique. He wrote about contemplating a jump from the bridge connecting the east and west banks of our campus. He was fixated on John Berryman, the Pulitzer Prize-winning poet who’d taught at Minnesota and committed suicide off that very bridge, which led us to spend valuable workshop time talking around our concerns for his well-being.

These delicate moments do come up, and when they do, sensitive and caring individuals will look to offer comfort; triage requires that we first attend to bleeding wounds. Yet should these situations (which any writing teacher will attest are unavoidable) discourage writers from sharing emotionally charged and personal material? And how can writing teachers acknowledge the complicated relationship between writing and real life without asking students to sanitize the works they present to class?

This tension bears out in Ann Patchett’s afterword to Lucy Grealy’s memoir Autobiography of a Face , which chronicles Grealy’s story of disfiguring jaw cancer. Patchett, who attended the Iowa Writers’ Workshop with Grealy, describes one of Grealy’s readings:

As the crowd in Rizzoli’s wept over the passage she read about being tortured by schoolboys in stairwells, my brave and heroic Lucy made it clear to the audience that she had no interest in being anybody’s inspiration. She was not there as a role model for overcoming obstacles. She was a serious writer, and she wanted her book to be judged for its literary merit and not its heartbreaking content. When people raised their hand to ask a question, more often than not that question turned out to be a statement of what they themselves had endured. Lucy refused to let the evening divulge into a litany of battle stories. . . . [S]he made her point: she was making art, not documenting an event. That she chose to tell her own extraordinary story was of secondary importance. Her cancer and subsequent suffering had not made this book. She had made it. Her intellect and ability were in every sense larger than the disease.

Grealy’s bristling at her readers is typical of the academic response to the emotional content of a memoir: We must not acknowledge the relationship between the content and the writer, lest the writer look like a flawed person and not a literary genius. Yet Patchett commits this very act when she calls Grealy “my brave and heroic Lucy.” Lucy Grealy was a very talented writer, but she was also a girl and a woman who endured the emotional and physical pain of a devastating disease. While it’s true that “her cancer and subsequent suffering had not made this book,” it’s also true that without cancer, there’d have been no book. Most readers don’t pick up a memoir because they imagine it will be literary masterpiece; they’re looking first and foremost for a compelling story. It’s unrealistic of writers to expect readers of memoir—a genre that by its very definition reveals the consciousness of the writer—not to connect with them, just as it’s unrealistic of writing teachers to surgically excise the emotional lives of writers from the material being written.

In 1997, Kathryn Rhett compiled a collection entitled Survival Stories: Memoirs of Crisis , which the New York Times book critic Michiko Kakutani critiqued as “conflat[ing] literature and therapy.” Kakutani took the book’s publication as an opportunity to decry everything wrong with the genre of memoir: “The current memoir craze has fostered the belief that confession is therapeutic, that therapy is redemptive and that redemption equals art, and it has encouraged the delusion that candor, daring and shamelessness are substitutes for craft, that the exposed life is the same thing as an examined one.” I’ve read that sentence many times, looking to find the lapse in logic. I certainly don’t argue with the first two assumptions: 1) “that confession is therapeutic” and 2) “that therapy is redemptive.” At the very least, confession has the potential to be therapeutic, just as therapy can be redemptive. It’s what follows—“that redemption equals art”—that causes the problem.

Kakutani takes issue with this idea. I agree that confession and redemption alone are no formula for good writing or art of any description, but that doesn’t mean that they can’t co-occur. And doesn’t a life have to be exposed—at least in part—before the writer can examine it? Why can’t a memoir speak about trauma or reveal family secrets and still be literary?

In fact, countless books do this well. They typically begin with the writer’s emotional turmoil simply because it’s an easy way to introduce conflict. Losing the Garden: The Story of a Marriage by Laura Waterman begins with the author’s husband leaving their secluded home in the mountains of Vermont to commit suicide. He has planned it out—if suicide can ever be considered a rational decision, a question the book seeks to resolve—and she has allowed him to leave. This memoir explores an act that’s strange and unthinkable. Likewise, Kathryn Harrison, in The Kiss , writes about her adult incestuous relationship with her estranged father. Some readers were put off by what was deemed the taboo nature of her subject (indeed, this may have dominated the conversation about the book), but I’d argue that the desire to read about these very private moments in the lives of others is not simply voyeuristic. It isn’t simply gawking. It’s a human instinct to witness another’s pain, to attempt to understand it, and, ultimately, to learn from it. We want to better know the human experience, the human condition; readers and writers of memoir are both in pursuit of thoughtful reflection.

Other books explore a more prosaic but no less harrowing type of family conflict. In his essay “Shame and Forgetting in the Information Age,” Charles Baxter considers this: “It is natural that a writer would want to write about parents, but recent memoirs seem to have reserved a special place for missing or empty or vacated or just bad fathers. Something has gone wrong with fathers; there is something either shameful or absent about them.” He goes on to name several books I’ve read and loved: Paul Auster’s The Invention of Solitude , Harrison’s The Kiss , Mary Karr’s The Liars’ Club . To his list I would quickly add Rick Bragg’s All Over But the Shoutin’ , J. R. Moehringer’s The Tender Bar , and Frank McCourt’s Angela’s Ashes . Readers want these stories not because they wish to eavesdrop on another’s misfortune, but because fathers are imperfect, because the parent–child relationship is a complex and messy one, because the universal can be understood through the specific.

The repetitions of subject matter, as well as the commercial and literary successes of these titles, suggest that memoir reaches the reader’s psyche in an important way and also that such stories can be thoughtfully crafted. So my struggle with Kakutani’s critique and professors’ disclaimers is that they tell novice writers of creative nonfiction to stay far away from sensitive subject material, from anything that might make the classroom uncomfortably resemble a therapist’s office. It was this dissonance that, for a long time, kept me from understanding that it was okay to write creative nonfiction, to create art in the form of text, and, concurrently, to find therapeutic value in the work.

From my experience in an MFA program, the academy doesn’t like to talk about the fact that writing emotionally driven memoir is, in fact, cathartic, at least initially. That’s the drafting stage—getting it out of one’s head and on to the paper—and sometimes the draft comes out sounding like, “My boyfriend—boy, was he a jerk.” If the writer doesn’t know what to do with the material, if she can’t see anything bigger than “this happened,” there are three choices.

First, toss it. Perhaps it was just a vent. No harm, no foul.

But I favor the other options. One of them: put it away for a while. When you return to revisit the work, you can try to make some sense of the raw material. This requires a critical examination of what’s on the page; it requires making choices about what belongs in the narrative and what must be cut. As William Faulkner famously said, “Kill your darlings.” To revise raw material, to bring a piece of writing to a satisfying conclusion, requires a resolution. I have written on a subject that felt important, but wasn’t able to conclude the piece, perhaps because the story was not yet resolved in my own life. That’s okay. I’ve generated raw material that can wait patiently for me to return someday.

The final option is to show the draft to others to see if they can spot a narrative thread worth developing. But this option is tricky, because it requires the writer to expose herself to others, to present her as-yet-unresolved problem—I’m depressed/I hate my mother/my boyfriend left me and I feel sad—and to ask her fellow writers if there’s anything worth developing. This is where writing teachers get uncomfortable because workshops sometimes sound like group therapy sessions. To help create distance between what’s on the page and the living, breathing writer in the room, writing programs encourage the use of language like “the character” or “the narrator.” But it’s inevitable that a story thread must be exposed before it can be examined.

Research has confirmed that writing about emotionally charged memories is good for the health of the writer—and not just her psyche. In April 1999, the Journal of the American Medical Association published a study that linked writing about stressful life experiences to improved health. But as reported in the Chicago Tribune , Joshua M. Smyth, the study’s co-author, cautioned, “It actually has little to do with raw catharsis, which, I think, is what people assume.” Smyth explains that the health benefits were a result of cognitive restructuring—learning to think about problems in a new way—along with changing levels of stress and anxiety. So while the initial writing—the first draft—may provide a cathartic effect, the lasting benefit comes from seeing the problem in a new light—the organizing, editing, and structuring of a piece of writing.

But what of the cathartic effect? Should we be so quick to dismiss it? I imagine catharsis as an evolutionary adaptation, nature’s mechanism of positive reinforcement. Catharsis feels good, so writers seek to recreate the experience, in this case by continuing to write about troubling experiences. This initial purge can lead to mulling over, which results in new ways of seeing old problems and an evolution of thought.

Writers, no matter their genre, find inspiration to write from the same source: something they hear or see or otherwise experience stays with them. They can’t stop musing; they must investigate. Writing is just another form of problem solving. Like psychology or medicine, it’s a drive to understand the human condition experientially, one that’s led by emotion and instinct. The success of a piece of writing is proven by readers connecting with the writer’s words, knowing on some basic level that what the writer has composed touches on a truth of human experience. For this reason, I’ve always encouraged my students to write on sensitive topics but with the understanding that the purpose of our class is to examine the narrative and aesthetic merits of what’s on the page, including—and especially—whether the emotion rings true. Finding a subject is an important part of developing as a writer. And if the writer receives any psychological benefit from constructing the narrative—and she very well may—that’s wonderful. On the other hand, if the material is especially raw and difficult to process, the writing process may lead to clarity, but working with a therapist can also help the writer order the emotion. It should come as no surprise that this may also help the writing.

Of course, not all generating leads to thoughtful examination, and not all drafts can be crafted into finished products. The point is, that isn’t the fault of the subject. Poorly run group therapy, where members do nothing more than complain about the same problems over and over again, doesn’t make people better, either; in fact, it can make them much worse, by reinforcing negative thought patterns. But both writers of memoir and those in therapy must reflect thoughtfully on their stories . . . which leads me to recalculate my reasoning from the start of this essay. When my instructor declared that writing creative nonfiction is distinct from therapy, she wasn’t actually seeking to “separate reflection, that fundamental element of creative nonfiction, from the task of general psychological introspection.” Reflection, quite simply, is psychological introspection. One is written while the other is oral, but both good writing and good therapy require a narrative to be ordered and assembled. Patricia Hampl’s words confirm this: “If we learn not only to tell our stories but to listen to what our stories tell us—to write the first draft and then return for the second draft—we are doing the work of memory.” What my instructor really meant to say is that it’s important to revise.

I began writing creative nonfiction because I felt an urgency to share my stories. Writing also provided an escape from my grief and a small way to raise the dead. But as Annie Dillard warns in her essay “To Fashion a Text,” “You can’t put together a memoir without cannibalizing your own life for parts. The work battens on your memories. And it replaces them.” As happens often enough, science has caught up with art to confirm this notion. Neuroscientists now tell us that the simple act of recalling and restoring changes the brain’s organic structure. The natural condition, it seems, is for stories and memories to change over time.

Dillard’s words proved true in my case. The struggle to go on living when someone I loved could not see value in his own life, the pain and the anger and the deep, pooling sadness—all these emotions began to fade after I saw the ink on the page. The writing process brought those feelings from inside me out into the sunlight. It said, “This happened. Your pain is real.” Catharsis was my initial motivator, but that alone didn’t sustain me. Generating, which sometimes comes easily, other times painfully, is only the first step in the writing process. The real work is in workshop, revision, and polishing the completed work.

I’ve come to love wrestling out an argument and polishing rhythmical prose. Perhaps the only recompense for tragedy—for death and loss of innocence—is the chance to create some measure of beauty. The marvel of a well-crafted sentence—finding just the right diction and syntax—is a small triumph over pain, a way to create order in the world. That world, at times, may be nothing more than a writer and her pen. Writers find pleasure in moments of flow, a loss of consciousness, but as any practitioner of meditation will tell, this is simply preparation to engage in the world and to develop a more refined consciousness. After all, what is the human experience if not an attempt to order pain and chaos?

Ms. DaPra, Ms. DaPra,

This piece has helped me “get it” when it comes to writing my memoir. Thanks.

Thank you, Tara Dapra, from a writer’s whose bio states, “I write because it’s cheaper than therapy.”

Thankyou for these insights Tara. As one embarking on my memoirs I find them invaluable.

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MSc in Creative Writing for Therapeutic Purposes

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About the course

Creative Writing for Therapeutic Purposes is a growing field of research and practice. This unique non-clinical MSc course gives students the opportunity to learn experientially through writing and discussion, to receive taught content on theory, and to develop skills and resources for working in the field of CWTP. The core values of the course are humanistic and person-centred, emphasising people’s potential for growth, change and movement in a positive direction in their lives. 

Time commitment: The programme is taught over 10 weekends per academic year, in each of the first two years – 7 weekends Live Online and 3 weekends In Person in Bristol UK (November, end of March, beginning of July - there is no online teaching on these days). Students require a   minimum   of 5 hours’ personal study time per week. Participants undertake a research project in Year Three.  

Contact days and hours are 09.00 - 17.00 BST

Please click here for a Summary of this course  and scroll down this page for video.

Who is this course for?

• People with an interest in writing in a broad sense including literature, stories, narratives and spoken word, and in how working with these can contribute to wellbeing on individual and social levels 
• People currently working, or aiming to work with others who seek training to prepare them for working with CWTP 
• People in other fields who wish to employ the resources and practices of CWTP to tackle problems, enhance organisations and communities, or envision pathways in diverse cultures and settings 

The course offers students opportunities    

• to engage with creative writing using diverse forms and approaches
• to find their own voice in practising CWTP 
• to build knowledge and skills with emphasis on the integration of theory and practice 
• engage experiential learning, group work, practical skills training, peer feedback, and creative and personal development 

Applicants are required to submit examples of their creative writing with a reflective commentary on the process of writing one or more pieces

To find out what our students say about the course:  click here.   

For a list of our diverse completed MSc CWTP research topics  click here  

For course dates   click here

To enquire further about the MSc in Creative Writing for Therapeutic Purposes please use the form below. Experienced CWTP practitioners can enquire about entering the course in Year Two via the Accredited Prior Learning Route.

If you have any queries or if you require more information please contact Cathy Simeon via email  [email protected]  

For academic related queries please contact Fiona Hamilton  [email protected]    

We also offer a  Practitioner Certificate in Creative Writing for Therapeutic Purposes for Therapists (click here)

This programme is validated and quality assured by Middlesex University and you will receive a Middlesex award on successful completion.

Middlesex University Programme Spec 

Metanoia Institute has begun the process to be able to award its own degrees. This will not affect students starting in 2023.  Please see here for further details

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WHS Creative Writing Team places fourth in state competition

Published 12:00 pm Monday, August 5, 2024

By Staff Reports

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The Windsor High School Creative Writing Team placed fourth in the Virginia High School League (VHSL) Creative Writing Competition.

Students from all districts and regions compete against each other in the categories of nonfiction, short stories, and poetry.

Marina Segreve, a recent graduate of WHS, placed second in Virginia with her nonfiction entry titled “Bittersweet.”

The rest of the team contributed to the overall team points to guide WHS to a fourth-place finish in the competition. The team is coached by Ginger Beatty-Riffle.

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Stanford Online

The creative habit: cultivate a daily writing practice.

CSP-XCW19WA

Stanford Continuing Studies

Creativity comes naturally to us from childhood, but “real life” often gets in the way, with critical voices and practical concerns suppressing the impulse to put our ideas on paper and make art. Even if you can barely remember the last time you wrote anything beyond an email, a text, or a grocery list, the seeds of creativity are still deep inside you and need only a little coaxing to flourish again. Writing just a little every day takes away the anxiety of the blank page and makes you more observant, more in touch with your creativity, and as a result, happier and more fulfilled. Every weekday, for five weeks, you will receive a prompt, from which you should freewrite for 30 to 60 minutes (or whatever you can spare). Weekends will be off, with optional short prompts for those wishing to sustain momentum. The daily prompts will encourage you to try creative nonfiction, fiction, and simple poetic forms. You may always approach a prompt from a different genre or angle. This course is for those who want to write without inhibition and have fun without an evaluative component. You may submit one 500-word piece each week for gentle instructor feedback, if you wish, and you may post your writing in a thread to give and receive peer feedback. We will forge a creative community and find the quality of heightened awareness that comes from using creative writing as a way of being more present in the world.

Malena Watrous Writing Certificate Lead and Creative Writing Coordinator, Stanford Continuing Studies

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142 Picture Prompts to Inspire Student Writing

A school year’s worth of short, accessible image-driven posts that invite a variety of kinds of writing.

By The Learning Network

We’ve been publishing our Picture Prompts series four days a week since 2016. Below, we’ve rounded up all the prompts we published for the 2023-24 school year.

These short, accessible, image-driven prompts invite students to pen short stories, poems and memoirs; share experiences from their lives; analyze illustrations, graphs and charts; and tell us their opinions on hot-button issues.

You can find even more in our roundups for the 2022-23 , 2021-22 and 2020-21 school years, as well as in our collections of 125 picture prompts for creative and narrative writing and 25 spooky images for writing scary stories .

To learn how you can use Picture Prompts to build literacy skills, promote critical thinking, inspire discussion and foster creativity in your classroom, watch our three-minute tutorial video or our on-demand webinar . For dozens more ideas, see our lesson plan “ How to Teach With Our Picture Prompts (and Other Times Images) .”

If you use this feature with your students, or if you have other ideas for how to use photos, illustrations and graphics to encourage writing, let us know in the comments.

Share experiences from your own life.

Boys and Cologne Soapbox Derby Graphs Old and Young 2,000 Bags Spring Holidays Baking Spring ‘Floor Person’ Checking Your Watch ‘Wild’ Ice Skating Lunar New Year Hot Pot Distracted Walking Breakfast Wild Weather Maps Healthy Habits Holiday Classics Compliments Family Drama Thanksgiving Dinner Libraries Scary Movies Carving Pumpkins Fall Friday the 13th Our Own Language Skydiving Lazy Days Back to School

What story does this image inspire for you?

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What do you think this image, chart or cartoon is saying?

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What’s your opinion on this issue?

‘Cowboy Carter’ New Stamp Design Prizewinning Miniature Poodle Cicadas for Dinner Met Gala Student Orchestra Tech in the Classroom Salt Movie Memorabilia 100 Years of Furniture March Madness Texting Styles Concerts Leap Day Broadway Shows Ice Cream Celebrity Feuds A.I.-Generated Faces World’s Largest Cruise Ship Your Energy Playlist Taylor Swift and the N.F.L. In-and-Out Lists Contenders Coveted Cup Your 2024 Most-Anticipated List 2023 in Pictures Style in 2023 $700 Million Deal Dream Décor Skipping School Giving Tuesday Pop-Tart Critic Time Change Pink Jersey Floating Home The Mall Breaking Police Robot Celebrity Relationships Fall Music New iPhone Tiny Homes Floods in Libya Football Season Land, Man and Sky Fall Video Games

Students 13 and older in the United States and Britain, and 16 and older elsewhere, are invited to comment. All comments are moderated by the Learning Network staff, but please keep in mind that once your comment is accepted, it will be made public and may appear in print.

Find more Picture Prompts here.

University of Minnesota Morris

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Humanists discover  and  create. They turn self-expression into art. They connect with cultures (including our own) by learning their languages and interpreting their creative achievements. They ponder the big questions a thoughtful mind cannot avoid and add their voices to the great conversation.

The humanities include:

• Art History
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A humanistic education was once reserved for the rich and ruling classes. This once made sense because a humanistic education prepares one to discuss the ultimate aims and pleasures of the state, law, politics, and culture. It is one of the great achievements of democratic educational institutions like Morris that a sort of education once reserved for aristocrats—instruction in Latin, philosophy, poetry—is now available to the rest of us.

Roughly, a field is more “humanistic” as opposed to “scientific” when expert judgment and good taste are necessary to evaluate the quality of the work under scrutiny. A humanistic education is essential in a world where interdisciplinary competence is increasingly necessary, and where leaders and professionals are expected to have both quantitative and qualitative skills. Humanities majors at Morris often double major in scientific or social-scientific fields and enrich their employment prospects and their personal lives by drawing together the skills they learn across our campus.

The Edward J. & Helen Jane Morrison Gallery

The Edward J. & Helen Jane Morrison Gallery is centrally located in the main floor in the Humanities Fine Arts Building. The facility can be ranked as among the best of galleries on small liberal arts campuses in the United States, offering the campus and community exhibits throughout the academic year.

The Hasselmo Language Teaching Center LTC consists of a computer facility including windows computers and one Apple/Macintosh faculty workstation and can accomodate a class of up to 25 students as well as a media screening room that includes a SMART television, a region-free DVD player, a VHS player, a PAL player, and a Google TV media streamer.

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The Writing Center offers students the opportunity to meet with one of our consultants (either a fellow student or an English instructor) about their writing. We can work with students on specific papers/assignments and on writing in general.

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• Knights of Moscow Oblast... Knights of Moscow...
• Burvenev vs. Panov Burvenev vs. Panov

Mikhail Burvenev vs. Aleksandr Panov

Fighter Comparison

1-0-0		Pro Record At Fight	Pro Record		2-1-0
Climbed to 2-0		Record After Fight		Fell to 2-2
Russia Russia				Russia Russia
25 years, 7 months, 3 weeks, 6 days	25 +7 mos, 3 wks, 6 days		Age at Fight		27 years, 5 months, 5 days	27 +5 mos, 5 days
		Height
Club Svyatogor, Shatura		Gym		N/A

Burvenev vs. Panov Fight Predictions

Fight predictions, tapology community picks: 0, bout information.

Fight Details

• Event: Knights of Moscow Oblast Ring
• Date: Monday 10.16.2017
• Enclosure: Ring
• Location: Roshal, Russia
• Bout Billing: Main Card (fight 2 of 2)
• Pro/Am: Professional
• Weight: 185 lbs (84.0 kg)
• Burvenev Total Disclosed Pay: Burvenev Disclosed Pay: None Disclosed
• Panov Total Disclosed Pay: Panov Disclosed Pay: None Disclosed

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WGS 84 coordinate reference system is the latest revision of the World Geodetic System, which is used in mapping and navigation, including GPS satellite navigation system (the Global Positioning System).

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Longitude is counted from the prime meridian ( IERS Reference Meridian for WGS 84) and varies from −180° to 180°. Positive longitude values correspond to the geographic locations east of the prime meridian (abbrev. E). Negative longitude values correspond to the geographic locations west of the prime meridian (abbrev. W).

UTM or Universal Transverse Mercator coordinate system divides the Earth’s surface into 60 longitudinal zones. The coordinates of a location within each zone are defined as a planar coordinate pair related to the intersection of the equator and the zone’s central meridian, and measured in meters.

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Elektrostal , Moscow Oblast, Russia