20 minutes per day for four days in a row
How to Do It
Over the next four days, you’ll write freely about your true feelings and thoughts about an experience of hurt that has been emotionally challenging.
- Find a comfortable time and place where you are unlikely to be disturbed. If a private space is not available, you can ask people not to disturb you while you’re doing this practice.
- Use any writing materials that are available to you. You can use a word processor, or physical notebook, binder paper, or even a piece of scratch paper.
- Choose an experience of hurt to write about that is important to you. Choose events or situations you feel you can handle now—that is, don’t write about a severe trauma too soon after it happened, or if it feels too overwhelming.
- In your writing, explore what’s been happening in connection to that hurtful experience, how it has affected you, and how it connects to different parts of your life. You might tie this experience to your childhood, your relationship with your parents, people you have loved or love now, or your career.
- As you write about your experience, really let go and write freely whatever comes to your mind. Don’t worry about spelling or grammar.
- Try not to edit or judge what you write. Remember that your writing is for your eyes only and that you are doing this for your own well-being.
- To the best of your ability, write without stopping for at least 20 minutes. Do whatever you need to help you stay on task–you might listen to music, wear noise-canceling headphones, and put away distractions.
- Optional: After the four days of writing, try writing from the perspective of a neutral observer or the perspectives of other people involved in the situation.
Why You Should Try It
Most of us have gone through times of great stress and emotional upheaval. This exercise gives you a simple, effective way to deal with these challenges and the difficult feelings they bring up. Research suggests that completing this exercise can increase happiness, reduce symptoms of depression and anxiety, strengthen the immune system, and improve work and school performance. These benefits have been shown to persist for months.
Why It Works
When we experience a stressful event or major life transition, it’s easy to ruminate over that experience; thinking about it can keep us up at night, distract us from work, and make us feel less connected to others. Expressive writing allows us to step back for a moment and evaluate our lives. Through writing, we can become active creators of our own life stories—rather than passive bystanders—and as a result feel more empowered to cope with challenges. Transforming a messy, complicated experience into a coherent story can make the experience feel more manageable.
Evidence That It Works
Pennebaker, J.W., Kiecolt-Glaser, J., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239-245.
Compared with a control group who wrote about superficial topics, participants who wrote about traumatic experiences for four consecutive days reported greater happiness three months later, visited the doctor less than usual during the six weeks after, and seemed to have a healthier immune system.
Who Has Tried the Practice?
While there is no demographic information in the study above, additional studies explore how this exercise benefits different groups and cultures:
- American psychiatric outpatients and people with mood disorders decreased in anxiety and depression after several sessions of Expressive Writing.
- Women undergraduate students in the U.K. who completed three Expressive Writing sessions reduced in eating disorder symptoms.
- Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people (mostly white or Asian American) who did Expressive Writing about a time they received hate speech became more resistant to stress.
- Gay and bisexual men who did Expressive Writing about their sexuality daily for three days improved in emotional well-being, became more open with their sexual orientation, depended less on illicit drugs, and reported more safe sex behaviors.
- Bilingual British undergraduates whose first language was Korean or Spanish improved in social well-being after four days of Expressive Writing, especially if they alternated between writing in English and their native language.
- Latino American and Chinese undergraduates engaged in up to three consecutive daily sessions of writing about a traumatic experience and showed reductions in trauma symptoms.
- American undergraduates, American war veterans, and British people who experienced psychosis (all with post-traumatic stress disorder) spent up to four consecutive days doing Expressive Writing about their trauma and showed mental health improvements.
- Chinese undergraduates who completed eight weekly Expressive Writing sessions reported improvements in psychological, social, and physical health.
- Japanese undergraduates who did three days of Expressive Writing improved in working memory capacity (a sign of mental health).
- British, Swiss, Italian, and Iranian mothers who recently gave birth engaged in up to 10 writing sessions in the hospital and reported reductions in maternal post-traumatic stress and depression.
- Female survivors of intimate partner violence, women with histories of childhood sexual abuse, and women with substance abuse disorders decreased in mental health symptoms after completing several sessions of Expressive Writing.
- People with various disabilities and diseases, including people who have experienced seizures, heart attacks, chronic pain, respiratory disorders, irritable bowel syndrome, lupus, fibromyalgia, rheumatoid arthritis, ankylosing spondylitis, kidney transplants, and various cancers (including breast cancer in white Americans, Chinese Americans, Chinese nationals, and Romanians) improved in mental or physical health after Expressive Writing.
More research is needed to explore whether, and how, the impact of this practice extends to other groups and cultures.
Keep in Mind
Some studies have found no changes in mental or physical health after a few days of Expressive Writing, for older adults in New Zealand, Danish breast cancer survivors, and colon and rectal cancer patients. The benefits of Expressive Writing may also vary based on gender, personality, or cultural experience:
- Expressive Writing may be more beneficial for women than for men. Among international students in America, Chinese undergraduates and medical students, and HIV-positive Americans, women showed more psychological improvement than men from Expressive Writing. In some cases, men did not show any improvements at all.
- Expressive Writing might require a certain mindset to be beneficial. For example, Expressive Writing was more helpful in decreasing distress for slightly neurotic gynecological cancer patients than highly neurotic patients. American breast cancer survivors increased in quality of life after Expressive Writing only if they were high in optimism and less avoidant of their trauma.
- In other cases, you may have more to gain from Expressive Writing if you are struggling more. For example, amyotrophic lateral sclerosis patients who had trouble expressing emotions showed more improvements in well-being from Expressive Writing than patients who did not have trouble expressing emotions. Expressive Writing helped decrease depression for Chinese international students in America who often ruminated on negative thoughts, while those who ruminated less increased in depression. And diverse international students in America who were highly stressed from cultural differences showed larger emotional improvements from Expressive Writing than those who were less stressed.
- The benefits of Expressive Writing may be limited for Asian Americans, especially if you write about trauma or cancer, or if you compare yourself to others in your writing.
While Expressive Writing can be beneficial, it may also bring up difficult feelings:
- The practice increased anxiety and sadness for perinatal women who had survived Hurricane Harvey.
- Newly diagnosed breast cancer patients reported high levels of anxiety and depression when they wrote about negative emotions.
- International students in America (mostly from India, China, Iran, Iraq, and Saudi Arabia) increased in positive emotions, but also increased in homesickness and fear, after Expressive Writing.
- For LGBTQ+ individuals, the benefits of Expressive Writing may depend on openness about your sexual orientation. In one case, white and Black lesbian Americans did Expressive Writing about sexuality-related trauma three times a week for two weeks. Lesbians who were less open about their sexuality decreased in confusion and stress, but lesbians who were more open about their sexual orientation actually increased in confusion and stress. This is possibly because lesbians who are more open do not regularly think about the prejudice they experience.
- British mothers who recently gave birth decreased in stress after Expressive Writing three times a week for two weeks, but many found it difficult to consistently engage in the practice.
James Pennebaker, Ph.D., University of Texas at Austin
The University of Texas at Austin Office of Public Affairs
Averill, A. J., Kasarskis, E. J., & Segerstrom, S. C. (2013). Expressive disclosure to improve well-being in patients with amyotrophic lateral sclerosis: A randomised, controlled trial. Psychology & Health, 28(6), 701–713.
Ayers, S., Crawley, R., Button, S., Thornton, A., Field, A. P., Flood, C., Lee, S., Eagle, A., Bradley, R., Moore, D., Gyte, G., & Smith, H. (2018). Evaluation of expressive writing for postpartum health: A randomised controlled trial. Journal of Behavioral Medicine, 41(5), 614–626.
Baikie, K. A., Geerligs, L., & Wilhelm, K. (2012). Expressive writing and positive writing for participants with mood disorders: An online randomized controlled trial. Journal of Affective Disorders, 136(3), 310–319.
Bernard, M., Jackson, C., & Jones, C. (2006). Written emotional disclosure following first-episode psychosis: Effects on symptoms of post-traumatic stress disorder. British Journal of Clinical Psychology, 45(3), 403–415.
Broderick, J. E., Stone, A. A., Smyth, J. M., & Kaell, A. T. (2004). The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions. Annals of Behavioral Medicine, 27(1), 50–59.
Chai, M., Yu, H., Liu, Y., Lu, Q., & Pan, F. (2014). Effect of short term expressive writing on stress reaction. Chinese Journal of Clinical Psychology, 22(6), 1128–1132.
Craft, M. A., Davis, G. C., & Paulson, R. M. (2013). Expressive writing in early breast cancer survivors. Journal of Advanced Nursing, 69(2), 305–315.
Crowley, J. P. (2014). Expressive writing to cope with hate speech: Assessing psychobiological stress recovery and forgiveness promotion for lesbian, gay, bisexual, or queer victims of hate speech. Human Communication Research, 40(2), 238–261.
Danoff-Burg, S., Agee, J. D., Romanoff, N. R., Kremer, J. M., & Strosberg, J. M. (2006). Benefit finding and expressive writing in adults with lupus or rheumatoid arthritis. Psychology & Health, 21(5), 651–665.
Darabos, K., & Hoyt, M. A. (2020). Emotional processing coping methods and biomarkers of stress in young adult testicular cancer survivors. Journal of Adolescent and Young Adult Oncology, 9(3), 426–430.
Di Blasio, P., Camisasca, E., Caravita, S. C. S., Ionio, C., Milani, L., & Valtolina, G. G. (2015). The effects of expressive writing on postpartum depression and posttraumatic stress symptoms. Psychological Reports, 117(3), 856–882.
East, P., Startup, H., Roberts, C., & Schmidt, U. (2010). Expressive writing and eating disorder features: A preliminary trial in a student sample of the impact of three writing tasks on eating disorder symptoms and associated cognitive, affective and interpersonal factors. European Eating Disorders Review, 18(3), 180–196.
Gallagher, M. W., Long, L. J., Tsai, W., Stanton, A. L., & Lu, Q. (2018). The unexpected impact of expressive writing on posttraumatic stress and growth in Chinese American breast cancer survivors. Journal of Clinical Psychology, 74(10), 1673–1686.
Gellaitry, G., Peters, K., Bloomfield, D., & Home, R. (2010). Narrowing the gap: The effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer. Psycho-Oncology, 19(1), 77–84.
Graf, M. C., Gaudiano, B. A., & Geller, P. A. (2008). Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research, 18(4), 389–399.
Halpert, A., Rybin, D., & Doros, G. (2010). Expressive writing is a promising therapeutic modality for the management of IBS: A pilot study. Official Journal of the American College of Gastroenterology, 105(11), 2440–2448.
Hamilton-West, K., & Quine, L. (2007). Effects of written emotional disclosure on health outcomes in patients with ankylosing spondylitis. Psychology & Health, 22(6), 637–657.
Henry, E. A., Schlegel, R. J., Talley, A. E., Molix, L. A., & Bettencourt, B. A. (2010). The feasibility and effectiveness of expressive writing for rural and urban breast cancer survivors. Oncology Nursing Forum, 37(6), 749–757.
Hevey, D., & Wilczkiewicz, E. (2014). Changes in language use mediate expressive writing's benefits on health-related quality of life following myocardial infarction. Health Psychology and Behavioral Medicine, 2(1), 1053–1066.
Hijazi, A. M., Tavakoli, S., Slavin-Spenny, O., & Lumley, M. A. (2011). Targeting interventions: Moderators of the effects of expressive writing and assertiveness training on the adjustment of international university students. International Journal for the Advancement of Counselling, 33(2), 101–112.
Hirai, M., Dolma, S., Vernon, L. L., & Clum, G. A. (2020). A longitudinal investigation of the efficacy of online expressive writing interventions for Hispanic students exposed to traumatic events: Competing theories of action. Psychology & Health, 35(12), 1459–1476.
Hirai, M., Skidmore, S. T., Clum, G. A., & Dolma, S. (2012). An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals. Behavior Therapy, 43(4), 812–824.
Horsch, A., Tolsa, J., Gilbert, L., du Chêne, L. J., Müller-Nix, C., & Graz, M. B. (2016). Improving maternal mental health following preterm birth using an expressive writing intervention: A randomized controlled trial. Child Psychiatry and Human Development, 47(5), 780–791.
Hoyt, T., & Yeater, E. A. (2011). The effects of negative emotion and expressive writing on posttraumatic stress symptoms. Journal of Social and Clinical Psychology, 30(6), 549–569.
Hsu, M. C., Schubiner, H., Lumley, M. A., Stracks, J. S., Clauw, D. J., & Williams, D. A. (2010). Sustained pain reduction through affective self-awareness in fibromyalgia: A randomized controlled trial. Journal of General Internal Medicine, 25(10), 1064–1070.
Ironson, G., O'Cleirigh, C., Leserman, J., Stuetzle, R., Fordiani, J., Fletcher, M., & Schneiderman, N. (2013). Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive, and HIV-disease-related outcomes: A randomized, controlled trial. Journal of Consulting and Clinical Psychology, 81(2), 284–298.
Jensen‐Johansen, M. B., Christensen, S., Valdimarsdottir, H., Zakowski, S., Jensen, A. B., Bovbjerg, D. H., & Zachariae, R. (2013). Effects of an expressive writing intervention on cancer‐related distress in Danish breast cancer survivors—Results from a nationwide randomized clinical trial. Psycho-Oncology, 22(7), 1492–1500.
Ji, L., Lu, Q., Wang, L., Sun, X., Wang, H., Han, B., Ma, Y., & Lu, G. (2020). The benefits of expressive writing among newly diagnosed mainland Chinese breast cancer patients. Journal of Behavioral Medicine, 43(3), 468–478.
Kállay, É., & Băban, A. (2008). Emotional benefits of expressive writing in a sample of Romanian female cancer patients. Cogniţie Creier Comportament, 12(1), 115–129.
Kim, Y. (2008). Effects of expressive writing among bilinguals: Exploring psychological well-being and social behaviour. British Journal of Health Psychology, 13(1), 43–47.
Knowles, E. D., Wearing, J. R., & Campos, B. (2011). Culture and the health benefits of expressive writing. Social Psychological and Personality Science, 2(4), 408–415.
Koopman, C., Ismailji, T., Holmes, D., Classen, C. C., Palesh, O., & Wales, T. (2005). The effects of expressive writing on pain, depression and posttraumatic stress disorder symptoms in survivors of intimate partner violence. Journal of Health Psychology, 10(2), 211–221.
Koschwanez, H. E., Kerse, N., Darragh, M., Jarrett, P., Booth, R. J., & Broadbent, E. (2013). Expressive writing and wound healing in older adults: A randomized controlled trial. Psychosomatic Medicine, 75(6), 581–590.
Krpan, K. M., Kross, E., Berman, M. G., Deldin, P. J., Askren, M. K., & Jonides, J. (2013). An everyday activity as a treatment for depression: The benefits of expressive writing for people diagnosed with major depressive disorder. Journal of Affective Disorders, 150(3), 1148–1151.
Lepore, S. J., Revenson, T. A., Roberts, K. J., Pranikoff, J. R., & Davey, A. (2015). Randomised controlled trial of expressive writing and quality of life in men and women treated for colon or rectal cancer. Psychology & Health, 30(3), 284–300.
Lewis, R. J., Derlega, V. J., Clarke, E. G., Kuang, J. C., Jacobs, A. M., & McElligott, M. D. (2005). An expressive writing intervention to cope with lesbian-related stress: The moderating effects of openness about sexual orientation. Psychology of Women Quarterly, 29(2), 149–157.
Lu, Q., Gallagher, M. W., Loh, A., & Young, L. (2018). Expressive writing intervention improves quality of life among Chinese-American breast cancer survivors: A randomized controlled trial. Annals of Behavioral Medicine, 52(11), 952–962.
Lu, Q., Wong, C. C. Y., Gallagher, M. W., Tou, R. Y. W., Young, L., & Loh, A. (2017). Expressive writing among Chinese American breast cancer survivors: A randomized controlled trial. Health Psychology, 36(4), 370–379.
Lumley, M. A., Keefe, F. J., Mosley-Williams, A., Rice, J. R., McKee, D., Waters, S. J., Partridge, R. T., Carty, J. N., Coltri, A. M., Kalaj, A., Cohen, J. L., Neely, L. C., Pahssen, J. K., Connelly, M. A., Bouaziz, Y. B., & Riordan, P. A. (2014). The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 82(4), 644–658.
Meshberg-Cohen, S., Svikis, D., & McMahon, T. J. (2014). Expressive writing as a therapeutic process for drug-dependent women. Substance Abuse, 35(1), 80–88.
Meston, C. M., Lorenz, T. A., & Stephenson, K. R. (2013). Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: Results from a randomized clinical trial. Journal of Sexual Medicine, 10(9), 2177–2189.
Milbury, K., Lopez, G., Spelman, A., Wood, C., Matin, S. F., Tannir, N. M., Jonasch, E., Pisters, L., Wei, Q., & Cohen, L. (2017). Examination of moderators of expressive writing in patients with renal cell carcinoma: The role of depression and social support. Psycho-Oncology, 26(9), 1361–1368.
Norman, S. A., Lumley, M. A., Dooley, J. A., & Diamond, M. P. (2004). For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain. Psychosomatic Medicine, 66(2), 174–183.
Pachankis, J. E., & Goldfried, M. R. (2010). Expressive writing for gay-related stress: Psychosocial benefits and mechanisms underlying improvement. Journal of Consulting and Clinical Psychology, 78(1), 98–110.
Paquin, V., Bick, J., Lipschutz, R., Elgbeili, G., Laplante, D. P., Biekman, B., Brunet, A., King, S., & Olson, D. (2021). Unexpected effects of expressive writing on post-disaster distress in the Hurricane Harvey study: A randomized controlled trial in perinatal women. Psychological Medicine, 1–9.
Pepe, L., Milani, R., Di Trani, M., Di Folco, G., Lanna, V., & Solano, L. (2014). A more global approach to musculoskeletal pain: Expressive writing as an effective adjunct to physiotherapy. Psychology, Health & Medicine, 19(6), 687–697.
Possemato, K., Ouimette, P., & Geller, P. A. (2010). Internet-based expressive writing for kidney transplant recipients: Effects on posttraumatic stress and quality of life. Traumatology, 16(1), 49–54.
Rabiepoor, S., Vatankhah-Alamdary, N., & Khalkhali, H. R. (2019). The effect of expressive writing on postpartum depression and stress of mothers with a preterm infant in NICU. Journal of Clinical Psychology in Medical Settings, 27, 867–874.
Rawlings, G. H., Brown, I., Stone, B., & Reuber, M. (2018). A pilot randomised controlled trial of a home-based writing intervention for individuals with seizures. Psychology & Health, 33(9), 1151–1171.
Sayer, N. A., Noorbaloochi, S., Frazier, P. A., Pennebaker, J. W., Orazem, R. J., Schnurr, P. P., Murdoch, M., Carlson, K. F., Gravely, A., & Litz, B. T. (2015). Randomized controlled trial of online expressive writing to address readjustment difficulties among U.S. Afghanistan and Iraq war veterans. Journal of Traumatic Stress, 28(5), 381–390.
Sheerin, C. M., Konig, A., Eonta, A. M., & Vrana, S. R. (2018). Effect of expressive and neutral writing on respiratory sinus arrhythmia response over time. Journal of Behavior Therapy and Experimental Psychiatry, 59, 129–133.
Smith, S., Anderson-Hanley, C., Langrock, A., & Compas, B. (2005). The effects of journaling for women with newly diagnosed breast cancer. Psycho-Oncology, 14(12), 1075–1082.
Smith, H. E., Jones, C. J., Hankins, M., Field, A., Theadom, A., Bowskill, R., Horne, R., & Frew, A. J. (2015). The effects of expressive writing on lung function, quality of life, medication use, and symptoms in adults with asthma: A randomized controlled trial. Psychosomatic Medicine, 77(4), 429–437.
Tavakoli, S., Lumley, M. A., Hijazi, A. M., Slavin-Spenny, O., & Parris, G. P. (2009). Effects of assertiveness training and expressive writing on acculturative stress in international students: A randomized trial. Journal of Counseling Psychology, 56(4), 590–596.
Tsai, W., Lau, A. S., Niles, A. N., Coello, J., Lieberman, M. D., Ko, A. C., Hur, C., & Stanton, A. L. (2015). Ethnicity moderates the outcomes of self-enhancement and self-improvement themes in expressive writing. Cultural Diversity and Ethnic Minority Psychology, 21(4), 584–592.
Tsai, W., Lee, C. S., & Monte, V. (2021). Comparing the effects of emotional disclosure and peer helping writing on psychological distress among Chinese international students: The moderating role of rumination. Journal of Clinical Psychology, 77(7), 1556–1572.
Wells, B. E., Samrock, S., Pawson, M., & Starks, T. J. (2021). Pilot randomized trial of an expressive writing intervention to reduce sexual HIV-transmission risk and substance use among emerging adult gay and bisexual men. AIDS and Behavior, 26, 584–595.
Yang, Z., Tang, X., Duan, W., & Zhang, Y. (2015). Expressive writing promotes self‐reported physical, social and psychological health among Chinese undergraduates. International Journal of Psychology, 50(2), 128–134.
Yogo, M., & Fujihara, S. (2008). Working memory capacity can be improved by expressive writing: A randomized experiment in a Japanese sample. British Journal of Health Psychology, 13(1), 77–80.
Zakowski, S. G., Herzer, M., Barrett, S. D., Milligan, J. G., & Beckman, N. (2011). Who benefits from emotional expression? An examination of personality differences among gynaecological cancer patients participating in a randomized controlled emotional disclosure intervention trial. British Journal of Psychology, 102(3), 355–372.
Zakowski, S. G., Ramati, A., Morton, C., Johnson, P., & Flanigan, R. (2004). Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Health Psychology, 23(6), 555–563.
Zheng, L., Lu, Q., & Gan, Y. (2019). Effects of expressive writing and use of cognitive words on meaning making and post-traumatic growth. Journal of Pacific Rim Psychology, 13, 6.