Writing Therapy


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Ernest Hemingway, F. Scott Fitzgerald, and  Virginia Woolf; while we can only speculate as to their DSM diagnoses, it is clear that each of these talented writers, as well as many of their peers, led tortured private lives. Those close to Hemingway initially described his death as an accident, but his struggle with depression was widely known. His wife eventually admitted to the press that he had committed suicide. Given the glamorization of alcohol and drugs in F. Scott Fitzgerald’s “The Great Gatsby” it is not surprising to learn that the author himself endured a lifelong battle with alcoholism. Virginia Woolf reportedly suffered from rapid cycling bipolar disorder, alternating between bouts of intense productivity in her writing and periods in which she was unable to get out of bed, let alone write.  Correlation does not imply causation, but it is possible that these authors self-selected into writing as a career because they recognized the therapeutic properties of writing and were hoping to work through some of their issues on paper.

Goals of Writing Therapy

Writing therapy is a therapeutic modality in which patients do just that—achieve emotional catharsis by allowing their feelings to flow freely from pen to paper. The writing can take on different forms, ranging from responses to written prompts, including poems and excerpts from literature, to simple, uninhibited expression of emotion. Writing of all kinds has been shown to be effective in reducing stress, blood pressure, and trauma-related cognitions and to interfere with ruminative thoughts contributing to symptoms of anxiety and depression (Pizarro, J., 2004; Smyth, J., 1998; Pennebaker, J., 1997). While art therapy, the genre from which writing therapy is derived, can offer similar benefits, writing therapy has been shown to be significantly more effective due to the added benefits of cognitive organization. Patients suffering from chronic health issues and post-traumatic stress disorder are among those for whom writing therapy has been found to be particularly effective.

When is Writing Therapy Used?

Not only is writing therapy a distinct mode of treatment in its own right, but it is also used as a common technique in other modalities. In fact, writing is one of the few therapeutic techniques to cut across seemingly contrary theoretical orientations. It is employed in both psychodynamic and cognitive-behavioral therapy.

How Writing Therapy Works

Within psychodynamic therapy, written and spoken introspection is encouraged. Journaling outside of session can be recommended as a way for a therapist to encourage continued work between sessions. This kind of writing can be used to help a client develop increased self-awareness and identify spots for further growth. In addition to such transcribed introspection, creative writing can be a therapeutic form of expression within psychodynamic theory. Creative writing is viewed as a type of sublimation, which is a defense mechanism in which an individual works through neuroses by transforming them into a form of art. Sublimation is considered to be one of the highest order, or most functional, defense mechanisms, signifying a mature adaptation to a socially unacceptable impulse.

Cognitive-behavioral therapy also makes use of writing as a therapeutic technique. Within this modality, therapists often assign written “homework” to clients for them to complete between sessions. Often times this involves clients completing daily thought records, which require them to write down various pieces of information throughout the day, including distressing events, corresponding thoughts and feelings, as well as ratings of moods. Through recording this data, clients can develop self-awareness of cognitive distortions that contribute to negative moods and learn to automatically deconstruct them in the moment. Writing is crucial to the process of internalizing the deconstruction of cognitive distortions.

Criticisms of Writing Therapy

Creative writing or journaling as a hobby could never serve as a substitute for mental health treatment. However, one can make use of writing as a way to maximize personal effectiveness or as an augment to treatment. Here are some ideas for how to incorporate writing into your life:

  • Keep a notepad by your bed and use it to record things that may be troubling you before you go to sleep. In doing so you are freeing up your subconscious and giving yourself permission to delay worrying about these things until tomorrow.
  • Create your own version of a thought record, keeping track of automatic thoughts, feelings, and moods attached to the various events that carry meaning in your life. Explore through written word the accuracy of your thoughts, remaining attuned to potential cognitive distortions.
  • Maintain a journal in which you keep track of your goals, both daily and long-term. Consider posting your goals on your desk, on your bathroom mirror, or on your refrigerator. Doing so adds a degree of accountability that will help you follow through on plans.


Pennebaker, J.W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162-166.

Pizarro, J. (2004). The efficacy of art and writing therapy: Increasing positive mental health outcomes and participant retention after exposure to traumatic experience. Art Therapy: Journal of the American Art Therapy Association, 21 (1), 5-12.

Smyth, J.M. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174-184.

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