From boosting confidence to providing an outlet for stress relief, expressive writing is a powerful tool for mental health and personal growth. It’s an opportunity to reflect and work with oneself and connect with one’s feelings. According to a study conducted by a researcher at the University of Houston (UH), writing down fears, emotions and the benefits of a cancer diagnosis may improve health outcomes for Asian-American breast cancer survivors.
“The key to developing an expressive writing intervention is the writing instruction. Otherwise, writing is just like a journal recording facts and events. Writing a journal can be therapeutic, but oftentimes we don’t get the empirical evidence to determine whether it’s effective or not,” said Qian Lu, assistant professor and director of the Culture and Health Research Centre at UH.
“In my research study, I found long-term physical and psychological health benefits when research participants wrote about their deepest fears and the benefits of a breast cancer diagnosis,” she said.
Writing about the diagnosis can reduce the psychological burden
The study “A Pilot Study of Expressive Writing Intervention Among Chinese-Speaking Breast Cancer Survivors,” conducted by Lu and colleagues, was published in the journal Health Psychology. Her research aims to lessen the psychological toll that minority patients—especially those who have survived breast cancer—take.
“Cancer patients, like war veterans in Iraq, can experience post-traumatic stress symptoms. Many times, when cancer patients get diagnosed, they face lots of emotional trauma. There’s a sense of loss, depression, anxiety about going into treatment and how they are going to face the future,” said Lu. “They have a lot of emotional events going on in their life.”
Lu discovered that the psychological needs of Asian-American breast cancer survivors received insufficient consideration in her research. She discovered that there was a need to investigate this understudied demographic because previous studies had mostly concentrated on non-Hispanic white populations. Among the difficulties she identified with this group were feelings of stigma, guilt related to cancer, cultural notions of taking responsibility alone to prevent upsetting harmony, repressing feelings, and a dearth of qualified mental health practitioners who are fluent in multiple languages and cultures.
“We thought of a very interesting way to help this problem. It’s basic. It’s to express emotions using writing,” she said. “What’s so interesting is that it has been proven as a scientific paradigm.”
The release offered by writing has a direct impact on the body’s immune function
Writing about emotionally taxing experiences for just 20 to 30 minutes at a time over three or four days boosted immune function, according to Lu’s earlier research. Writing provided a release that directly affected the body’s ability to tolerate stress and fend off illness and infection.
“I based my study for Chinese-speaking breast cancer survivors on Pennebaker’s research paradigm, and we have conducted a series of studies to modify the paradigm for Asian-Americans” said Lu.
Lu collaborated with a community-based partner to find volunteers rather than visiting a hospital. After completing a standardized health examination, participants in Lu’s research team were required to write for 20 minutes per week for three weeks. The participants received three sealed envelopes at the same time, each carrying a distinct set of writing instructions for the corresponding week. Three and six months following the completion of the writing tasks, participants received questionnaires evaluating health outcomes. After the 6-month follow-up, semi-structured phone interviews were carried out.
“The findings from the study suggest participants perceived the writing task to be easy, revealed their emotions, and disclosed their experiences in writing that they had not previously told others. Participants reported that they wrote down whatever they thought and felt and perceived the intervention to be appropriate and valuable,” said Lu.
Lu continued, “After three months, there is a reduction in fatigue, intrusive thoughts, and posttraumatic stress disorder linked to the expressive writing intervention.” After six months, she also reported less weariness, PTSD, and an increase in life quality and good affect.
Lu added that health outcomes associated with the expressive writing intervention include a decrease in fatigue, and intrusive thoughts, and reducing posttraumatic stress after three months. She also noted a decrease in fatigue, and posttraumatic stress, and the increase of quality of life and positive affect after six months.
Materials provided by the University of Houston. Original written by Melissa Carroll. Note: Content may be edited for style and length.
University of Houston. “Expressive writing may help breast cancer survivors.” ScienceDaily. ScienceDaily, 1 August 2014. <www.sciencedaily.com/releases/2014/08/140801171120.htm>.
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