Writing down thoughts and feelings about a troubling issue over several days can be helpful, but don’t expect it to cure anything

24. Writing down thoughts and feelings about a troubling issue over several days can be helpful, but don’t expect it to cure anything

Cost: This costs nothing. Typical practice in studies is to write 3–4 times, each session lasting 15–20 minutes. Write about something that bothers you and express your deepest thoughts and feelings.

In plain terms: Writing about upsetting matters generally provides a small benefit on average, though the results are inconsistent. Two meta-analyses found no effect at all. Since it costs almost nothing, it’s worth trying. However, if emotional problems are severe, it should not replace professional medical care.

Benefit: One meta-analysis combined data from 146 randomized studies in which participants wrote or spoke about personally important topics. On average, the effect was positive and statistically significant, though very small (effect size r =.075). Another meta-analysis limited to randomized controlled trials found no significant effects on either physical or mental health across 30 trials. For 16 trials involving cancer patients and survivors, there were no significant improvements in psychological, physical, or quality-of-life outcomes; the effect size for psychological outcomes was g = 0.04, with a 95% confidence interval ranging from –0.06 to 0.14.

Evidence grade: B

Sources: Frattaroli J (2006). Experimental disclosure and its moderators: a meta-analysis. Psychological Bulletin. <https://doi.org/10.1037/0033-2909.132.6.823>; Mogk C, Otte S, Reinhold-Hurley B, Kröner-Herwig B (2006). Health effects of expressive writing on stressful or traumatic experiences - a meta-analysis. Psycho-Social Medicine. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736499/>; Zachariae R, O'Toole MS (2015). The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients--a systematic review and meta-analysis. Psycho-Oncology. <https://doi.org/10.1002/pon.3802>

Notes: This approach remains controversial. Proponents point to the 146-study meta-analysis showing a small positive effect, while critics cite two meta-analyses of randomized controlled trials that found no significant benefits. The recommended frequency and duration of writing sessions come from the original experimental designs, as summarized in Mogk’s meta-analysis. This method is included here because it requires virtually no expense or time and can be done alone. It may be useful when someone has no one to talk to about their problems. The time-based measurement used here reflects how authors categorized effort levels. If writing becomes increasingly distressing, stop and dial 12356, as described in Section 1, Item 25.