BY FIONA MULLEN
Expressive writing may be helpful for people who are having difficulty coming to terms with a stressful event such as a cancer diagnosis. Expressive writing can potentially enable us to integrate disruptive life events into our minds and help shape our emotional responses and goals for the future. Research has demonstrated both the psychological and health benefits of expressive writing in the context of stressful events.
Given that more than one third of cancer patients develop symptoms of depression or anxiety within 5 years of a diagnosis, the benefits of expressive writing deserve more attention. The practice of this writing form presents opportunities for both cancer patients and survivors to translate a traumatic experience into a statement of growth. This growth can be equated with enhanced resilience. Resilience refers to the ability to maintain or quickly recover to a healthy mental state during or after exposure to stressful life circumstances.
However, individuals should aim to receive guidance in the practice because a lack of guidance can result in them engaging in unhelpful coping behaviours such as rumination. Rumination is when people repetitively focus on their negative emotions, increasing the probability that a depressed mood will become a depressive disorder. It should be noted that expressive writing is not recommended for individuals who are still suffering intensely from the changes invoked by a stressful event. In this case, it is recommended you talk to your GP.
For expressive writing to be beneficial, it is suggested that you identify something positive in the stressful life event. The writing must also involve the building of a narrative that allows the authors to stand back and adopt a broader perspective. Lichtenthal and Neimeyer (2012) provide the following guidance for expressive writing in the context of a loss. They suggest it is important to write for 20 to 30 minutes on several occasions drawing on the intentions of “sense making’ and “benefit finding”.
Sense making entails writing about how and why the issue has occurred. This might include consideration of the following:
• how you have made sense of the event over time
• philosophical or spiritual beliefs that supported you
• how your direction in life has changed as a result of the event
Benefit finding involves reflecting on the positive significance of a stressful event. In this case:
• has your sense of yourself changed in terms of values, goals and priorities?
• what has contributed to your resilience?
• what positive qualities have you discovered in others?
• is it possible to cultivate gratitude for anything you have been given?
• do you relate to others differently?
For expressive writing to work, people must write about both their thoughts and feelings. Writing just about the events or just about emotions is not sufficient to bring about change. Expressive writing allows people to move through the traumatic experience and as a consequence they don’t think about it as much. Expressive writing changes the event itself, the way it is thought about, and in the way it is remembered. As the event is reshaped in the person’s mind, the corresponding emotions have to change as well.
In conclusion, expressive writing is presented as a potentially significant way to enhance your resilience in the face of the multiple challenges associated with a cancer diagnosis. However, it is important to recognise that you may require professional help at different points along the cancer trajectory.