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Healthy people after experiencing emotionally challenging situations, can carry unprocessed emotions for many decades, be it childhood angst, conflicts with family and friends, or remorse over missteps and lost opportunities. For almost twenty years, during several scientific studies, researchers asked participants to write about a disturbing experience for 15 to 20 minutes a day for three or four consecutive days. The point of the exercise is not to craft a perfect essay, but to dig deeply into one’s emotional baggage, then translate the experience into language on the page.

An analysis of the participants’ writing about trauma found that those whose health improves most tend to use a higher proportion of negative emotion words than those associated with positive emotions. The growing use of insight, and associated cognitive words over several days of writing is also linked to health improvement. The creation of a coherent story, with the expression of negative emotions, work together in therapeutic writing. Evidence of these processes are seen in the immediate improvement in autonomic nervous system activity.

In my opinion, this research confirms the ancient truth, “to thine own self be true.” Self-honesty allows the realization that we have the inherent capacity to define every experience, regardless of the depths of emotional pain it may have caused, rather than allow the experience to define us. We all possess the psychological and spiritual wherewithal to survive all experiences. We also equally possess the ability to heal and to thrive.

The investigators are not certain as to the precise way writing effects the body and makes it effective medicine. Until 1999, research in this area had focused on healthy individuals. Dr. Joshua Smyth and colleagues studied the effects of journaling in individuals experiencing asthma and rheumatoid arthritis. The study is believed to be the first using standardized, quantitative outcome measures to examine how writing about stressful events affects specific illnesses.

The study included 112 patients, 61 asthmatics, and 51 rheumatoid arthritics. 58 asthmatics and 49 arthritics completed the study. Patients were assigned to write either about the most the most stressful event of their lives or emotionally neutral events for only three days, 20 minutes each day. Four months later, nearly half of those who wrote about stressful events such as car accidents, abuse, divorce, or sexuality, had improved significantly. Asthma patients improved lung function by 19% on average. Patients with rheumatoid arthritis, had a 28% improvement of symptoms.

“We can do a good job with medication, but we can do a better job if we also pay attention to people’s psychological needs,” said Dr. Smyth, now an assistant professor of psychology at North Dakota State University.

“This indicates that a very minimal psychological social interaction can have very substantial medical effects. And it indicates that stress may play a role in the progression of illnesses like arthritis and asthma.”

Published in the April 14, 1999, issue of the Journal of the American Medical Association Dr. Smyth wrote, “Were the authors to have provided similar outcome evidence about a new drug, it likely would be in widespread use within a short time. Why? We would think we understood the ‘mechanism’ (whether we did or not) and there would be a mediating industry to promote its use.

“Manufacturers of paper and pencils are not likely to push journaling as a treatment addition for the management of asthma and rheumatoid arthritis. But the authors have provided evidence that medical treatment is more effective when standard pharmacological intervention is combined with the management of emotional distress. Ventilation of negative emotions, even just to an unknown reader, seems to have helped these patients acknowledge, bear, and put into perspective their distress.

Want to find out more about holistic health, then visit Elaine R. Ferguson, MD’s site on how to choose the best journaling for your needs.

I still clearly recall, almost 35 years later, my initial encounter with a dying patient. It was during my psychiatry clinical rotation in my second year of med school at Duke University. I’d been asked to interview a women with terminal malignant melanoma who was depressed.

She was only a few years older than me. Yet her body more closely resembled that of an elderly woman than a woman in her twenties. Her depression was palpable and filled the room. She knew she didn’t have a lot of time remaining. The thought of leaving behind her young children and husband was understandably unbearable. I was overwhelmed.

I left the hospital to sit for a few moments in the beautiful garden located behind it. Amidst the flowers, I let go of my sadness for her seemingly unavoidable death. A half an hour or so later, while reporting my interview to a supervising resident. I asked, “Do you think her depression will hasten her death?” I’ll never forget his reply. “No. According to research, there are only seven existing psychosomatic diseases where emotions play a role.”

My response was complete and instinctive disagreement. I remember thinking, “You’re wrong. That’s utter hogwash.” I knew, disregarding my limited experience, that emotions played an important role in the development, course and reversal of disease–and the creation of health.

Medical science now acknowledges the impact that thoughts, feelings, and moods can have not only in the development of certain diseases, but also on the course of many and on the management of probably all. Our health status is strongly influenced by mood, coping skills, and social support.

Yet, our approach to treating disease continues to overlook these factors, and fails to include them in our drug and surgery treatment focus. We continue to ignore the psychological needs of our patients.

This crucial mismatch between the psychosocial health needs of patients and the usual medical response leads to frustration, ineffectiveness, and wasted health care resources. By helping patients manage not just their disease, but also common underlying needs for support, health outcomes can significantly improve in an efficient and cost-saving manner.

Keeping a journal is one such solution. During my early adolescence, I started to keep a diary. There was something very magical in placing my feelings about the events in my life in a book. The process has continued to be part of my life since that time.

About twenty years ago, I discovered in fact there is a scientific basis for expressive writing, also known as “journaling.” While attending a health conference, I heard Dr. James Pennebaker, at the time a research psychologist at Southern Methodist University, talk about the events that led him to begin research in a new area: the psychology of expressive emotion.

Dr. Pennebaker shared with the audience that his research began after hearing an interview with a man who confessed to a murder that he’d kept secrets for several months, and was not suspected by the police. He was surprised that the man expressed great relief, despite the fact that his confession assured that he’d spend the rest of his life in prison. Dr. Pennebaker questioned if the emotional relief he observed in this man, caused measurable physical changes. It prompted him to conduct a study to determine the benefit of expressing suppressed and unresolved emotions through expressive writing.

His research projects consisted of having subjects write for 15 to 20 minutes a day, for four consecutive days, about emotionally challenging topics and experiences. At the completion of the studies he discovered that his subjects demonstrated significant physiological changes that correlated with mean increased immune system functioning. These positive changes remained for up to six weeks after the end of the four-day writing experiment. The participants reported fewer visits to health clinics and medical doctors for stress-related illnesses, even months later.

Learn more about how to get well. Stop by Elaine R. Ferguson, MD’s site where you can find out all about mind body health and what it can do for you.