Self-expression: A Solution For Traumatic Times
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Self-expression: A Solution For Traumatic Times

Talk about your trauma and pain or put on a happy face? Research suggests that expressing painful thoughts and feelings may help reduce the risk of illness.

Charles is a 37 year-old engineer who lost his wife in a fatal car accident six months ago. When asked how he was coping with the death, he responded, "I keep busy with my projects. I have an active social life and have developed new interests. To be honest with you, I've been too busy to sit around and cry about things...and I don't want to bring other people down. I've just accepted that my life isn't going to be the same anymore."

Meg is a 50 year-old mother of three whose husband died in a car crash two years ago. She has a different coping style than Charles. "I've been in counseling since John's death and joined a support group. I've found additional support from family members, friends, and through prayer."

By outward appearances, Charles seems to be resilient in the face of his wife's death, while Meg spends many emotional days and nights talking about and openly grieving her tragic loss. But whose coping style is really the healthiest?

The Dangers of Inhibition

In 1982, James Pennebaker, PhD, a psychologist at the University of Texas, conducted research on the surviving spouses of suicide and car accident victims. He found that those who talked and expressed feelings about their spouse's death had remarkably fewer physical and emotional health problems during the year after the death than those who did not.

According to Dr. Pennebaker, additional studies have demonstrated that not talking about major life stressors, past or present, is a health risk. Such stressors include:

  • Death
  • Job loss
  • An accident
  • Rape
  • Abuse
  • Suicide
  • Divorce
  • Marital infidelity
  • Other painful or traumatic experiences

Not talking about them (inhibition) has been linked to:

Personality Plays a Role

People with an inhibited personality or a repressive coping style are most at risk. They are typically cautious, restrained, and rarely disclose their deepest thoughts and feelings, traits that are esteemed in American society. But because these individuals tend to crave order and predictability, they have an especially difficult time being flexible, acknowledging emotions, and opening up to others when faced with trauma.

In his book, Opening Up: The Healing Power of Expressing Emotions, Dr. Pennebaker cites studies that have suggested that chronic inhibition may be linked to elevated cholesterol and blood pressure levels, may increase the risk of developing certain immune system disorders and, in breast cancer patients, may increase the risk of early death. Extreme inhibition has been implicated in the severity of diabetes, asthma, anorexia nervosa, and disturbed pain thresholds.

"Actively holding back feelings can be stressful," says Dr. Pennebaker. "People seem to have an underlying urge to confess. Inhibition is not pleasant for most of them."

In Good Times and in Bad

Surprisingly, Dr. Pennebaker cites several studies that suggest that even positive events such as receiving a promotion, getting married, having a baby, or winning the lottery may contribute to health problems if they are not talked about. It's healthy to openly express positive as well as negative emotions.

Letting the Cat Out of the Bag

As far back as the late 1800s, physicians Sigmund Freud and Joseph Breuer believed in the value of talk therapy as a way of discharging pent-up feelings and psychic tension.

Additional benefits of talking about a stressor or trauma may include:

  • Increased insight into the event
  • Greater self-understanding
  • Facilitation of the "letting go" process
  • Improved moods
  • A more positive outlook

Before You Confide: Things to Consider

Before you share your deepest thoughts, feelings, or secrets with another person, keep in mind that choosing the wrong person as a confidante could do you more harm than good. It's very important that you find a trustworthy, non-judgmental, supportive confidante who will not share what you have told her or him. You may want to find a therapist, someone who can provide you with objectivity as well as anonymity.

What if you prefer not to talk? According to Dr. Pennebaker, there are a number of ways we can express our thoughts and emotions in addition to talking with a friend, a support group, or a therapist. Other effective modes of emotional expression include talking into a tape recorder, keeping a journal, writing letters, praying, or engaging in dance, art and music therapies.

The "Write" Preventive Medicine

Studies involving grade-school children, nursing home residents, arthritis sufferers, medical school students, maximum security prisoners, new mothers, and rape victims, have suggested that writing about emotional upheaval improved physical and emotional health. In other studies, writing about emotionally difficult experiences helped people reduce anxiety and depression, find new jobs, and get better grades in college.

Writing about your deepest thoughts and feelings can be good medicine and it's easy and inexpensive. Here are a few things you need to consider before using this method of self-expression:

  • Experiment—Writing may or may not help you in dealing with emotional conflicts, depending on the issue you're confronting. If you find it doesn't help you, try other methods of self-expression, and above all, don't use writing to avoid taking direct action with a problem.
  • Choose a topic—Your topic should be an issue that you find yourself thinking or dreaming about frequently. It may be something that you are afraid or embarrassed to express openly.
  • Let go—Don't censor your writing. For this reason, your writing should be kept strictly to yourself. Don't worry about grammar or spelling. Write about the experience itself as well as your deepest feelings about the experience. Think about what you feel and why you feel that way.
  • Don't expect to feel better right away—Many people find that they feel sad and depressed for an hour or so after writing about an upsetting experience. This is especially true for those who are writing about a present trauma such as death or divorce. For the majority of people, however, writing eventually brings relief and more positive moods.
  • When others need to self-disclose—Sometimes we don't know what to do when a friend has suffered from the death of a loved one or has experienced some other trauma. We may avoid bringing up the trauma for fear that it will make the individual upset. This approach is usually not helpful. Chances are, our friend is thinking about the trauma a great deal and needs to talk about it. One of the most supportive things we can say to a friend in crisis is, "Please feel free to talk about it."

References:

Goleman D. Emotional Intelligence: Why It Can Matter More Than IQ. Bantam Books; 1995.

Pennebaker JW. Opening Up: The Healing Power of Expressing Emotions. Guilford Press; 1997.



Last reviewed November 2007 by Theodor B. Rais, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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