In his book Opening
Up: The Healing Power of Expressing Emotions, Dr. James Pennebaker
describes in detail his research on the health benefits of writing. By walking
the reader through the various studies that have influenced both his personal
thoughts and the direction of his research, Dr. Pennebaker exposes both the
strengths and limitations of writing as a coping method. Active inhibition
appears to have negative effects on the immune system. Those who experience
some sort of trauma but never disclose the event to others commonly experience
this phenomenon. However, simply by writing about the event, these individuals
can reduce their active inhibition and thereby increase their immune
functioning.
Although self-disclosure can result in demonstrable increases
in immune functioning, simply the act of writing itself cannot produce these
changes. Writing that reflects low-level thinking, such as writing about
superficial topics, has no health benefit for the writer. In order for one’s
health to benefit, one must engage in critical self-reflection about the topic
and the emotions that thinking about the topic raises. In particular, the
people who experienced the most health benefits were those who could construct
coherent stories when discussing their traumas. What benefits these people
experienced were not permanent (physician visits would be reduced for
approximately four months and no longer) and were further constrained by the
personality and coping styles of the individuals. Those who already had a “roll-with-the-punches”
coping style evidenced no added benefit from writing and those who were low
disclosers (i.e., people who become highly physiologically aroused when asked
to disclose) experienced more health problems and illnesses in the months after
being asked to disclose.
Additionally, the people whose health did benefit from
writing in the months after the experiment actually became more depressed and
sickly in the first few days/weeks after writing. This is not to say that
writing should not be utilized as a therapeutic method. As compared to other
self-expressive therapies such as art and expressive movement, writing produces
gains in both immune function and the cognitive understanding the patient forms
of their trauma. The act of translating events or traumas into language appears
to have health benefits beyond simple self-expression, because writing requires
the individual to reflect on their emotions as opposed to simply experiencing
them.
Out of the diverse selection of books I could have chosen
from to write this blog, I picked Opening
Up specifically because I had previously read one of Dr. Pennebaker’s
scientific articles on the subject. As a professor of Psychology at University
of Texas at Austin, Dr. Pennebaker is indisputably both an expert in health
psychology, and the leading researcher in the therapeutic effects of writing.
His book is especially credible and scholarly in that it is a chronicle of the
largest scientific findings he has made in this area of research. I believe
that it was a good choice of book for me, if for no other reason than my
personal interest/investment in the practice of health psychology. In fact, I
believe the best audience for this book would specifically be health psychology
students, whether they are at the undergraduate or graduate level. Although
this book could be potentially useful for anyone who has ever experienced
trauma or illness, the focus of the book is so narrow and Dr. Pennebaker’s
writing style so academic that I cannot imagine this book holding laypersons’
attentions for very long. In fact, many
psychology students with no interest in health could easily become bored with
this book as well, despite its obvious scientific and practical value. There is
very little overlap between this text and our social psychology course (there
is some discussion of ironic mental processes in avoiding traumatic thoughts
and belief in a just world as both protective and damaging when searching for
meaning in events), and this book could be an interesting source of information
for anyone interested in learning about some of the different ways social
psychology can be implemented in other fields.
Unfortunately (or fortunately), because of my personal
health problems I found this book especially applicable to my everyday life.
Where I grew up, I was always surrounded by the traumas of others. Whether I
was hiding out a friend at my house because a biker gang was threatening to
shoot up her house, listening to yet another girl disclose to me how her
stepfather had molested her, or helping pick out clothes to send to drug
dealers who were trying to turn their lives around with my mom’s help, there
was always something. And whatever that something was, it always took its
physical toll on me. I was born
premature and have been prone to sickness my whole life, but my immune system
became especially poor after my first depressive episode. So, at twelve some
part of me intuitively understood that to stay well physically and emotionally
I would have to write. Writing became my only emotional release in a town where
I knew my problems were nothing compared to…well, the problems of every other
person I encountered. As long as I had a
roof over my head, three meals a day and a family who loved me, I had no right
to complain. I was experiencing the social cost of my friends’ disclosures
about their lives to me. As I was always the listener, I experienced the
physiological arousal that the discloser was relieved of when they lowered
their inhibitions to confide. To continue as a confidante, I had to find a way
to lower my own inhibition or I risked becoming burnt out and losing
friendships. Writing provided a safe, emotional release for me so that I could
act as more than just a repository of others’ traumas.
Years later, in the early stages of my Lyme disease, writing
became my only means of understanding the changes that were happening in my
body. I had notebooks full of my rage at the doctors who dismissed my pain,
full of self-loathing and feelings of worthlessness, and full of the fire that
was burning me alive with every synapse. My immune system stayed intact until
the words eventually stopped flowing. The cognitive fog had finally claimed the
only method I had to understand the world I was slipping into. Once the words
stopped coming, the constant infections crept back. Upon choosing to read this
book, I decided to fight back again. Those of you who have read some of my
other blog posts will have noticed they can be brutally honest. I decided to
use these blog posts as a means of forcing myself to shed my inhibitions in
hopes I could change what has been one of the worst periods of immune
functioning in my life. I can’t attest to any change in my immune functioning
(except perhaps in a negative direction) but I can attest to the emotional
benefits of disclosure after experiencing the initial pain of writing. Perhaps
I am a low-discloser and this project has actually harmed my immune system. I
can’t be sure. I can be sure, however, that constructing my life experiences
into stories has helped me put those experiences into perspective. I tend to
think of myself as weak, but realizing that I have seen and been through more
at 21 than many people will experience in a lifetime helps me understand what
I’m truly capable of. My story is a painful one, but maybe it will be worth
listening to someday.
What I enjoyed most about Opening Up, was the very practical guidelines that Dr. Pennebaker
set forth so that the reader could potentially try to implement the findings of
his research in their everyday lives. However, the largest strength of the book
in my opinion was that although he set forward these guidelines, he made it
perfectly clear that writing is not some cure-all, magic bandaid. There are
obvious limitations to who benefits from writing and the extent to which they
will benefit. Writing is not a substitute for counseling or medicine; it is
primarily a preventative practice to help protect the immune system from the
cumulative effects of stress or trauma.
Personally, I found his discussion of the social cost of
disclosure to be the most useful. When you disclose intimate problems to love
ones, often they reach a point at which they can no longer bear the stress of
listening to your problems. The result is that when you most need support, your
social support system often rejects you out of discomfort. Reading about this
issue made me realize that my friends here haven’t abandoned me because I’m
inherently worthless or unlovable. They’ve done it because they’re a bunch of
fucking assholes who just don’t know what to say to me anymore. They want to be
around someone who will make them feel at ease instead of someone who is in
pain and wants to form a real human connection with them. So, fuck ‘em. I
realize that this section of the book was probably meant to make people
undergoing hard times realize that this is a normal human reaction and that
they should empathize with the people who can’t relate to them. I don’t like
that interpretation. The interpretation that my friends are dicks because that
can’t overcome a simple cognitive aversion so that they could help a person in
need is a much more useful interpretation for me. Just reiterate: fuck those
fucking assholes.
Someone who is not as angry or petty as I am would most
likely find Dr. Pennebaker’s discussion of the fundamental human drive to find
meaning most useful. Although most of us would most likely consider a drive
towards meaning an overwhelmingly positive endeavor, Dr. Pennebaker does a
fantastic job of pointing out how that drive can lead us to erroneous thinking,
such as victim blaming. Trying to find a simple cause and effect relationship
where there is none can cause irrevocable damage, which is why we should learn
to accept the limitations of our understanding.
The one thing I disliked about the book and found to be its
largest shortcoming was the very complicated and confusing relationship that
emerged from Dr. Pennebaker’s use of the words trauma and illness. At
times, the two words almost become interchangeable. This tendency is present in
my discussion of his work as well. I will fully admit that in trying to discuss
this topic, it becomes nearly impossible to disentangle the two terms. The
problem most likely stems from the divide between the actual topics of Dr. Pennebaker’s
research (i.e., asking people to write about trauma) and the applications of
his research (i.e., potential benefits for the chronically ill and disabled.)
Although living with illness can have the same emotional impact of certain
traumas on certain people, it is problematic to assume that illness itself is a
trauma. Traditionally, traumas refer to specific, discrete events with
long-lasting emotional impact. Illness is not an event in itself. Illness is a
part of your body and a part of you, right down to the microcellular level. How
can my body be a trauma? Unfortunately, I have no way of conceptualizing a
response to this question. From personal experience I know that living with
illness can feel like a trauma, but if doctors begin to consider the body as a
trauma, how might this affect the self-concepts of the chronically ill?
Finally, the one thing I would consider the “take home
message” of this book is that you should always listen to your body. Never take
for granted that an infection is just an infection. There can be very
complicated psychological factors in play that you are not fully appreciating.
Always think to yourself, “Have I been under any particular stress that might
have impaired my immune system, leaving me susceptible to catching this
infection?” Don’t take any changes in your body for granted.
(n = 1,975)
References
Pennebaker, J. W. (1990). Opening up: The healing power of expressing emotions.
New York, NY: The Guilford Press.