A prescription for writing in medicine
October 29th, 2010
06:21 PM ET

A prescription for writing in medicine

Writing has always been a prominent part of medicine. Doctors write “histories” of their patients all the time—brief for ordinary office visits, extensive for admissions to the hospital. Some medical schools use creative writing to help students gain empathy and insight.

There are doctors who write more publicly—from Anton Chekhov and William Carlos Willams to Oliver Sacks and Jerome Groopman—bringing medicine beyond the clinic walls.

Patients, too, have been writers. William Styron’s "Darkness Visible" could be seen as one of the most important “textbooks” on depression that exists.

Increasingly, though, there has been interest in writing for ordinary patients (ie, those not planning novels for the New York Times bestseller list.) The fledgling field of expressive writing, or writing therapy, has been gaining traction as a viable addition to the medical armamentarium.

In one of the earliest studies from 1996, patients with asthma and rheumatoid arthritis exhibited a decrease in symptoms after writing about the most stressful even of their lives.

A more recent, though preliminary, study using writing for patients with irritable bowel syndrome (IBS) also suggested positive benefit. A group of 82 patients did four 30-minute sessions, writing about their “deepest thoughts, emotions, and beliefs regarding the disease and their perception of its effects.” Compared with 21 patients who did not participate in writing, the writing group showed a significant improvement in symptoms. Interestingly, this improvement was still present three months later.

IBS—though biological in origin—is potently affected by psychological factors. Patients commonly report that stress worsens their symptoms. The mere act of writing might have reduced stress. Or perhaps the writing exercises helped patients work through some of the practical or emotional challenges of life with a chronic illness.

Many other diseases are felt to be less influenced by psychological factors, but the truth is that every patient—to some degree—has reactions to adjusting to an illness, even a broken leg resulting from tripping on the stairs.

Could writing be used more widely with patients? There seems to be little down side, except the investment of time. Compared with the side effects of medications that we routinely prescribe to patients—stomach upset, dizziness, weight gain, sexual dysfunction—writing seems fairly benign. And no one needs to call an insurance company for prior approval.

The only caution I might see is with patients who might write about severe traumas in their lives, stirring up painful memories. For these patients, doctors need to be prepared for powerful emotions, and must be able to provide timely referral to a psychologist or psychiatrist if needed.

With the exception of writer’s cramp—and perhaps writer’s block—writing therapy seems like a promising adjunct therapy for certain patients. I think I might start stocking extra pads and pencils in my clinic.

Danielle Ofri is associate professor of medicine at New York University School of Medicine and editor-in-chief of the Bellevue Literary Review. Her most recent book, “Medicine in Translation: Journeys with My Patients,” is about the care of immigrants and Americans in the U.S. health care system.

soundoff (6 Responses)
  1. Dr Bill Toth

    Would be writers curious about this topic might want to read "The artist's way" by Julia Cameron or Stephen King's "On Writing" for some explanations as to WHY writing heals on multiple levels. Live With Intention, DrBillToth.com/blog

    October 31, 2010 at 09:40 | Report abuse | Reply
  2. nowathriver

    I have been writing for years as a method of healing from childhood sexual abuse. It is a wonderful outlet for emotion, and a great way to organize your thoughts. I would caution people to be under the care of a trained therapist, however, as the emotions can sometimes be a bit overwhelming. It is also helpful to share the writing with your therapist IF you so desire. I do follow a method that my therapist has recommened in addition to a free flow of thought. It helps me to keep focused on healing and seeing the truth in my trauma. It can be easy to be swept away in the maelstrom of emotions otherwise.

    Another method is art therapy. You do not have to be talented for this to help – my drawings a little more than stick figures. Sometimes when a memory, or image, is stuck in my head drawing it out and discussing it with my therapist is extremely helpful.

    October 31, 2010 at 21:36 | Report abuse | Reply
  3. Rajiv

    Many people have been victims of some form of Sexual Trauma. This could range from severe ritualistic abuse which may have occurred repeatedly over a span of time or a single episode of rape, date-rape or non-consensual sexual contact

    November 1, 2010 at 07:21 | Report abuse | Reply
  4. Dr. Dave

    I also would not recommend writing about chronic pain, that can get people too focused on the symptom, and not enough on their life. But, a huge benefit is seen in people trying to quit who write "Goodbye Letters" to their drug of choice: alcohol, cannabis, nicotine! It is a great help to those who are able to write about their dual-relationship with the drug, and how the drug turned on them after seeming a friend– or some related theme that they choose.

    November 1, 2010 at 09:52 | Report abuse | Reply
  5. обозреватель

    Кто играл в Старкрафт2? Интиресует прохождение последней миссии там где Рейнер спасает Кериган. Если кто проходил не поленитесь отпишите плиз.

    May 21, 2011 at 03:39 | Report abuse | Reply
  6. tygojinna

    Уже очень много существует высказываний, что ТСЖ, видимо, создавать надо. Но вот вопрос. Какое именно ТСЖ, в каком виде, с какой схемой (моделью) управления – об этом пока что-то не очень основательно говорится.
    Так если ТСЖ создать, то какое из всего того многообразия вариантов, которые сегодня реально существуют и возможны?

    April 28, 2013 at 16:25 | Report abuse | Reply

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