Expressive writing

Writing that is used to release emotions, work through a difficult event, or gain an understanding of what someone is feeling is often called expressive writing. Expressive writing can be part of talk therapy with a licensed therapist, an activity you do with a formal writing group, or something you do on your own.

It’s important to know that while expressive writing can be helpful for some people, the Society for Integrative Oncology does not recommend expressive writing for improving symptoms of anxiety or depression.

Benefits of expressive writing

Expressive writing has been shown to help people diagnosed with cancer in different ways, including:

• Easing physical symptoms
• Reducing fatigue
• Improving quality of life

Research shows that expressive writing seems to be most helpful for people who have finished active treatment.

Still, studies of expressive writing have not shown significant improvements in symptoms of anxiety or depression in people with cancer. For this reason, the Society for Integrative Oncology-American Society of Clinical Oncology (ASCO) guideline does not recommend expressive writing for people with cancer who have anxiety or depression.

How expressive writing works

Expressive writing research suggests that it may be helpful to write about your thoughts and feelings about cancer in three to four 20-minute sessions over a period of days. Putting your experience into words may help you to take a step back and understand it more clearly.

If you want to try expressive writing on your own, here are some tips:

• Set aside at least 20 minutes alone to write for each session.
• Write without worrying about how the writing turns out. Grammar, spelling, and logic don’t matter. The goal is to get your feelings out.
• Try writing once a day for 3 to 4 days, but limit your time to 20 minutes, especially at the beginning. Some research suggests that writing every day for a longer period of time may cause a person to focus on negative feelings instead of releasing them.

Expressive writing isn’t the same as keeping a journal. When writing in a journal, you write your deepest thoughts and feelings. Expressive writing makes you focus on telling the story of your experience. In an expressive writing session, you create the full story with as much detail as possible, explaining emotions by describing how the scene looks and feels. Instead of your inner thoughts, it reads as if you’re telling your story to someone else, even if you are the only person to read it.

What you write may be very personal. You don’t have to share it with anyone. You could even throw the writing away, delete it, or tear it up when you are finished.

If you want the support of others in a similar situation, you might consider joining a writing therapy group available through some cancer and community centers or online. In a formal group, you get the guidance of a professional writing coach who can help you write in a supportive, safe place.

Ask your cancer center social worker or nurse navigator if the hospital offers any expressive writing groups, or if there are groups in your area.

Many groups meet in small, 8- to 10-person sessions for 1-2 hours a week over the course of several weeks. The writing coach helps the group write about their cancer experiences.

The format of group sessions is largely up to the writing coach. You might:

• Open by reading and discussing a piece of writing by a published author with cancer
• Begin by writing something of your own
• Be asked to read your writing aloud or respond to the writing of others

Joining a group gives you the opportunity to meet others who are going through the same things as you, share your feelings in a way that is unique to you, and have the support of a trained professional.

What expressive writing costs

The cost of formal writing therapy will vary based on rates set by the writing coach. It is rarely covered by insurance.