Open Up! Writing About Trauma Reduces Stress, Aids Immunity

Writing about difficult, even traumatic, experiences appears to be good for health on several levels - raising immunity and other health measures and improving life functioning.


Deep disclosure improves mood, objective and subjective health, and the ability to function well. Classic studies by psychologist James W. Pennebaker, PhD and his colleagues have proved the health value of personal disclosure. In a classic 1988 study by Pennebaker, Kiecolt-Glaser and Glaser, 50 healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for four days in a row. Six weeks after the writing sessions, students in the trauma group reported more positive moods and fewer illnesses than those writing about everyday experiences. Furthermore, improved measures of cellular immune-system function and fewer visits to the student health center for those writing about painful experiences suggested that confronting traumatic experiences was physically beneficial.

Pennebaker followed up in other settings. At the Dallas Memorial Center for Holocaust Studies, he and his colleagues videotaped interviews with more than 60 Holocaust survivors while taking their physiological measurements. Later, they classified each survivor, based on the interview, as a low, midlevel or high "discloser." High and midlevel disclosers were significantly healthier a year after the interviews than the low disclosers.

A joint 1994 study by psychologists and outplacement firm Drake Beam Morin followed 63 professionals who had been laid off from their jobs for eight months after they were assigned to one of three writing conditions. In the experimental condition, participants were instructed to write about their deepest thoughts and feelings about the layoff and about how their lives, personal and professional, had been affected. In the control condition, participants were told to write about their plans for the day and their job search activities. In the no-writing condition, participants were given no particular writing instruction. After five consecutive days of 30-minute writing sessions, researchers started tracking employment status. Participants who wrote about losing their jobs were much more likely to find new ones in the months following the study.

Extending the research to medical patients, in 1999, Joshua Smyth and Arthur Stone and colleagues at SUNY at Stony Brook assigned patients with asthma and rheumatoid arthritis either to write about the most stressful event of their lives or to write about a neutral topic. Four months later, asthma patients in the experimental group showed improvements in lung function and arthritis patients in the experimental group showed a reduction in disease severity. In all, 47 percent of the patients who disclosed stressful events showed clinically relevant improvement, whereas only 24 percent of the control group exhibited such improvement.


Findings like these underscore that writing is an easy, inexpensive, independent and relatively universal way for people can resist the mental and physical ravages of stress and disease. Research findings that disclosure aids hiring and even improves grade-point average highlight the practical value of disclosure in some form.

Practical Application

Anyone who has benefited from keeping a diary or a journal can further justify the time and effort, secure in the knowledge that disclosing innermost thoughts and feelings - even or especially about bad experiences -- is good for health. Therapists increasingly encourage patients to undertake writing exercises outside of the clinical setting. Meanwhile, bookstores do a brisk business in selling blank journals and there are books and even a magazine that guide people through the process.

Cited Research

Pennebaker, J.W. (1997). Opening Up: The Healing Power of Expressing Emotion. New York: Guilford Press.

Pennebaker, J. W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, Vol. 56, pp. 239-245.

Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis. Journal of the American Medical Association, Vol. 281, pp. 1304-9.

Spera, S. P., Buhrfeind, E. D. & J.W. Pennebaker, (1994). Expressive writing and coping with job loss. Academy of Management Journal, Vol. 37, pp. 722-733.

American Psychological Association, October 23, 2003