Expressive Writing – A Proven Tool For Chronic Pain Relief

"Suppressed grief suffocates, it rages within the breast, and is forced to multiply its strength." – Ovid

The title of this blog may make you cringe if you hate to write. But don’t stop reading just yet, because the writing that may reduce your chronic pain or anxiety is NOT the same kind of writing you might recall from English class. Journaling or expressive writing pays no attention to sentence structure, correct spelling, or punctuation. Who wouldn’t have enjoyed this English teacher’s class? Keep reading for how you can use Expressive Writing as a Tool for Chronic Pain Relief.

A Way to Let Go

Psychotherapy is a good place to start if you’re dealing with a traumatizing event. But in the case of chronic pain, writing can be an effective tool in your pain-management toolbox. Therapy focuses on labeling “the problem” and discussing its causes and consequences—a feedback process that helps patients better understand their current feelings and emotions. Writing does not employ feedback. In fact, writing can be a totally private activity that gets thrown in the garbage or burned. 

In the case of chronic pain, the goal through writing is to let our unspoken or unexpressed thoughts about our pain, or the injury that started it all, be expressed. Medical experts have studied the results of “just stuffing” feelings. Holding in anxiety or anger is a sure way to become frustrated and explosive or hopeless and depressed. Maybe you’ve experienced this when the pain is intense or prevents you from doing something you really want to do. Seeing a therapist every time we hurt might not be practical, but writing can be done anytime, anywhere. We speak through writing, and this can release some of the tension that builds up when we have no one to talk to.

So let’s explore how this works and how it can help you deal with pain. 

Trauma and the Brain

Traumas (job loss, divorce, major health challenge, injury, losing a family member, the carnage of war) trigger powerful emotions like anger and fear. It’s natural to want to talk about the experience with others. But sometimes we think telling and retelling our story will alienate friends and family, reopen old wounds, be humiliating or embarrassing. So we intentionally “stuff” it and try to go on with life. We do this with our chronic pain, too, because we sense that talking about it with friends or family seems to drive them away. They probably want to help, but don’t know how to, so they make excuses to not spend as much time with us.

Why "Stuffing" Our Feelings is Stressful

The problem with inhibiting discussion about personal traumas or chronic pain is that the brain holds the memories—along with the emotions we feel—in a special “library.” We think and behave from our emotional memories—whether we want to or not. 

Researchers have discovered that inhibiting the emotions of a memory increases the sympathetic nervous system response we refer to as “fight-or-flight” mode —resulting in long-term stress. A situation that would normally cause a few moments of anger or frustration can push someone into a rate or a full-blown panic attack. When the stress of chronic pain is added to everyday tensions, we also become more vulnerable to pain flares.

Thinking About the Problem

Just thinking about a traumatic time in our life over and over again embeds it in the brain as an obstacle or enemy. We can get very good at remembering an unfortunate event or injury—so good that it’s like swimming too close to a “whirlpool,” where we get sucked in and can’t get out. Fast forward to now, when something overwhelms or irritates us, our brain flips through memories and connects fear and danger to the thing that is elevating our fight-or-flight response now. What we lack when this happens is the ability to think rationally, and we don’t have a go-to plan that assures our brain that this irritation or temporary problem isn’t life-threatening. For more tips on handling fear and anxiety, read these posts: Becky's #1 Pain and Anxiety-Management Tool and 10 Ways To Reduce Fear and Anxiety

Writing About the Problem

What the brain needs at this point is assurance that the over-sensitive fight-or-flight response is not warranted for the current situation. It turns out that expressing our feelings about an emotional experience (especially one that we’ve stuffed away or can’t discuss with anyone) is a way to achieve this, according to Dr. James Pennebaker, a key researcher on Expressive Writing.

“Writing about stressful situations is one of the easiest ways for people to release the negative effects of stress from their bodies and their lives.” – James Pennebaker, PhD

Learn how expressive writing can be an effective method to help manage chronic pain[/caption]

Why Does Writing Help?

It’s long been known that when we inhibit or don’t talk about an important psychological phenomenon, it becomes a stressor. So Dr. Pennebaker reasoned, “just as constraining thoughts, feelings, or behaviors linked to an emotional upheaval is stressful, letting go and talking about these experiences should, in theory, reduce the stress of inhibition.” Since talking about traumatic experiences and feelings is limited by who we choose to talk to and who listens, writing is a way to “talk” things out in a completely private way.

What is Expressive Writing?

In Dr. Pennebaker’s studies, writing groups were asked to write 15-30 minutes for 3-5 consecutive days about their deepest thoughts and feelings surrounding an extremely important emotional issue that has affected their lives. 

Expressive writing includes any of these aspects of the traumatic experience:

• Emotions, feelings, thoughts

• How the topic is tied to relationships with others (parents, lovers, friends, relatives—past or present)

• Exploring who you are now, who you have been in the past (child or adult), or who you would like to be

Writing may be about the same issue or experience on all days of the exercise, or on different events each day. Don’t worry about spelling, sentence structure, or grammar; but do handwrite (researchers conclude that tapping on a keyboard doesn’t allow the same body-brain connections). Once you begin, keep writing for the entire session. Just let your mind wander on the feelings and emotions you experience about this situation or topic.

Express Your Thoughts Freely

Writing allows privacy and freedom to express without worrying about another’s reaction. Once an experience is verbalized (or written), we can better understand it and relegate it to memory without inhibited emotions, rather than allowing it to invade our every moment. At the completion of this 3-5 day exercise, destroy what you’ve written. You will not benefit from re-reading it.

Some Self-Care is Warranted When Writing

If you get into the writing and feel you cannot write about a certain event because it brings on too much emotion or fear, stop writing and do something actively soothing, or seek support. Expect to feel a bit sad during or right after expressive writing, especially on the first day or two. Usually, this feeling goes away completely in an hour or two.

Researchers have observed the following benefits from Expressive Writing

Health Outcomes

• Fewer stress-related visits to the doctor

• Improved immune system functioning

• Reduced blood pressure

• Improved lung function

• Improved liver function

• Fewer days in the hospital

• Improved mood/affect

• A feeling of greater psychological well-being

• Reduced depressive symptoms before examinations

• Fewer post-traumatic intrusion and avoidance symptoms

Social and Behavioral Outcomes 

• Reduced absenteeism from work

• Quicker re-employment after job loss

• Improved working memory

• Improved performance in sports

• Higher grade point average for students

• Altered social and linguistic behavior

"Talk it Out" on Paper

Rather than focusing on a problem or pain until we feel worse, expressive writing can be an effective way to “talk” it out on paper so our brain feels like it’s been heard. It’s private. It’s safe. And it’s not graded with a red pencil! 

Because pain is a mind-body issue, not just the result of a physical injury or disease, using tools that rewire the brain can produce lasting relief and healing. In the case of memories that haunt us and cause recurrent anxiety, having a tool such as expressive writing available allows us to “talk” about how we feel and it gives the brain assurance that emotions and feelings can be experienced without a repeat trauma. Now the brain will begin to reassociate moments of frustration and anxiety with solutions we learn and practice.

Thank you for reading Expressive Writing - A Proven Tool for Chronic Pain Relief. We hope you found these tips helpful. If you want more tips to manage chronic pain, please check out our blog: How to Stretch to Reduce Pain

Resources

Physicians and researchers on this subject include Michael H Moskowitz, MD; Marla Golden, DO; Norman Doidge, MD; Daniel Amen, MD; and John Sarno, MD.

James W. Pennebaker. Writing About Emotional Experiences as a Therapeutic Process. Psychological Science, Vol. 8, No. 3, May 1997, Special Section.

Evans, J. F. (2005) Write Yourself Well. Psychology Today. 

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