Writing Your Feelings: Good Medicine For Chronic Conditions

Asthma and arthritis patients who for several days wrote down their feelings about a stressful event in their lives showed significant improvement in their conditions during a four month study, but a comparison group of patients who wrote instead about their plans for the day improved only half as much, a team of scientists report in the April 15 Journal of the American Medical Association.

"Although it may be difficult to believe that a brief writing task can meaningfully impact health, this study replicates in a chronically ill sample what a burgeoning literature indicates in healthy individuals," say Joshua M. Smyth, PhD, and Arthur A. Stone, PhD, and their colleagues.

Previous studies showed that healthy individuals who perform similar writing tasks report fewer medical symptoms, greater well being, and less use of health care services, but until now, the impact of writing down thoughts and emotions had not been explored in people with chronic health conditions, such as asthma and rheumatoid arthritis, say Smyth, of the North Dakota State University Department of Psychology, and Stone, of the Department of Psychiatry, State University of New York at Stony Brook.

The investigators had 48 asthma patients and 35 arthritis patients write about the most stressful experience in their lives for 20 minutes on three consecutive days. A comparison group of 22 asthma patients and 21 arthritis patients wrote instead about their plans for the day. All the patients continued with their regular medical care and their condition was evaluated after two weeks, two months, and four months.

The investigators found that nearly half (47 percent) of the patients who wrote about their feelings showed clinical improvement after four months compared with 24 percent of those in the control group.

The asthma patients who wrote about stressful events had a 19 percent increase in lung function, on average, whereas those in the comparison group showed no change. Arthritis patients who wrote about stressful events showed a 28 percent average reduction in the severity of their disease, while those in the comparison group showed no change.

The investigators say it remains unclear why writing about one's feelings is effective medicine. In previous research, healthy persons who completed the task found it emotionally upsetting, but also showed positive changes in various physiological health measures, including heart rate, blood pressure, and immune function.

"It is possible that such affective or physiological responses can explain our results," the investigators say.

Alternatively, it is possible that the writing task changed the way people thought and remembered previous stressful events in their lives, and helped them cope with new stressful events.

The researchers note that it is not yet known whether the writing task remains effective beyond the four-month period studied and whether it can produce similar results in patients with other chronic conditions. They also caution that writing certainly should not replace qualified treatment.