As a writer and trauma researcher, I’m fascinated by the connection between writing (an act), healing (a process), and health (a state). In clinical practice and in workshops and courses I’ve led, I’ve seen first-hand how the process of revealing painful experiences through the written word can provide healing insight and relief. In my own life, I’ve also felt its curative effects. So, when I began my study of moral trauma, specifically moral injury, and moral distress, I was curious how writing might provide a similar benefit.

It is well documented that narrative disclosure, that is, recalling and renegotiating a traumatic story, is considered an important component of the healing process; self-inhibition of negative emotions can lead to continuous autonomic arousal and poorer health (Pennebaker et al., 1988; van der Kolk, 2014). It is also well documented that expressing one’s deeper thoughts and feelings through writing can result in significant physical and psychological health benefits in the short and long term (Baikie & Wilhelm, 2005; Frattaroli, 2006; Frisina et al., 2004; Harris, 2006; Pennebaker, 2004; Smyth, 1998; Travagin et al., 2015).

“Writing to heal”—also known as expressive writing, emotional writing, written disclosure, and writing therapy—has become a sought-after source of research and a tool in clinical practice from disciplines including psychology, psychiatry, medicine, social work, and religious/spiritual studies. In the three decades since James Pennebaker first introduced the healing writing paradigm, others, including myself, have variously adapted the process.

One approach that has garnered much attention is written exposure therapy (WET; Sloan & Marx, 2018), an evidenced-based, scripted trauma-focused treatment for post-traumatic stress disorder (PTSD). The goal of WET is to use writing, specifically “let-it-all-go” writing (meaning fast, unrestrained, and emotionally focused), to engage thoughts and feelings about traumatic memories so that they can be adequately processed.

WET differs from other evidence-based psychotherapies, such as cognitive processing therapy (CPT), that include writing components in that it is brief, includes limited therapist involvement, and uses writing as the focus of exposure to and processing of the traumatic experience (Dawson et al., 2021).

Despite the demonstrated benefits of WET and other writing therapies, writing is still a form of exposure, the treatment for which can be anxiety-producing. Writing about traumatic experiences is generally associated with an immediate increase in short-term distress and negative affect, the likely result of activation of the sympathetic nervous system. Such distress can impair top-down cognitive functions of the prefrontal cortex while intensifying emotional responses (Arnsten et al., 2015). As a result, the act of writing can become more difficult, trigger a process of rumination, and produce........

© Psychology Today