‘Not like rose-tinted glasses… like taking a pair of dirty glasses off’: A pilot intervention using positive emotions in expressive writing

Studies conducted in various contexts and with varied populations have found expressive writing enhances physical and psychological wellbeing. This pilot intervention study countered the predominantly quantitative evidence by adopting a qualitative methodology, exploring the experience of using positive emotions in expressive writing. Participants (n = 10), who all had previous experience in expressive writing, were asked to select one of ten positive emotion cards (PECs) each day for three days. Participants were then asked to write expressively through the ‘lens’ of their chosen emotion. Semi-structured interviews were conducted and experiences were evaluated using Thematic Analysis. The results identified two main themes that compared the experience of expressive writing both with and without the PECs. The first theme, Processing (without the PECs) contained three sub-themes: sense of relief, habitual perspective and reactive to experience. The second main theme, Progressing (with the PECs) contained three different sub-themes: sense of direction, changed perspective and interactive with experience. This study found that, for expressive writers, positive emotions may function in three ways: to relate to others or self-expand, to move past challenges cognitively or change unconstructive perspectives, and finally as a way to interactively link or ‘bridge’ from the written subject matter to constructive action, thus breaking cycles of reactive writing and rumination. Implications of the study on the practice of expressive writing and its potential as a positive psychology intervention (PPI) are discussed.

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations

Background Writing therapy to improve physical or mental health can take many forms. The most researched model of therapeutic writing (TW) is unfacilitated, individual expressive writing (written emotional disclosure). Facilitated writing activities are less widely researched. Data sources Databases including: MEDLINE, EMBASE, PsychINFO, Linguistics and Language Behavior Abstracts, AMED, and CINHAL were searched from inception to March 2013. Review methods Four TW practitioners provided expert advice. Study procedures were conducted by one reviewer and checked by a second. Randomised controlled trials (RCTs) and non-randomised comparative studies were included. Quality was appraised using the Cochrane risk of bias tool. Unfacilitated and facilitated TW studies were analysed separately under ICD-10 chapter headings. Meta-analyses were performed where possible using Revman 5.2. Costs were estimated from an NHS perspective and three cost-consequence case studies were prepared. Realist synthesis followed RAMESES guidelines. Objectives To review the clinical and cost-effectiveness of TW for people with long-term health conditions (LTCs) compared to no writing, or other controls, reporting any relevant clinical outcomes. To conduct a realist synthesis to understand how TW might work, and for whom. Results From 14,658 unique citations, 284 full text papers were reviewed and 64 studies (58 RCTs) were included in the final effectiveness reviews. Five studies examined facilitated TW, these were extremely heterogeneous with unclear or high risk of bias, but suggested that facilitated TW interventions may be beneficial in individual LTCs. Unfacilitated expressive writing was examined in 59 studies of variable, or unreported, quality. Overall there was very little or no evidence of any benefit reported in the following conditions (number of studies): HIV (six); breast cancer (eight); gynaecological and genitourinary cancers (five); mental health (five); asthma (four); psoriasis (three); chronic pain (four). In inflammatory arthropathies (six) there was a reduction in disease severity (n= 191, standardised mean difference (SMD) - 0.61 [95% confidence intervals (95% CI) -0.96, -0.26]) in the short term on meta-analysis of four studies. For all other LTCs there was either no, or sparse, data with no, or inconsistent, evidence of benefit. Meta-analyses conducted across all the LTCs provided no evidence that unfacilitated EW had any effect on depression at short term (n= 1,563, SMD -0.06, 95% CI -0.29 to 0.17, substantial heterogeneity), or long term (n= 778, SMD-0.04 95% CI -0.18 to 0.10, little heterogeneity) follow up, or on anxiety, physiological or biomarker-based outcomes. One study reported costs, none reported cost-effectiveness, twelve reported resource use; meta-analysis suggested reduced medication use but no impact on health centre visits. Estimated costs of intervention were low, but there was insufficient evidence to judge cost-effectiveness. Realist review findings suggested that facilitated TW is a complex intervention and group interaction contributes to the perception of benefit. It was unclear from the available data who might benefit most from facilitated TW. Limitations Difficulties with developing realist review programme theory meant that mechanisms operating during TW remain obscure. Conclusions Overall there is little evidence to support the effectiveness or cost-effectiveness of unfacilitated expressive writing interventions in people with LTCs. Further research focussed on facilitated TW in people with LTCs could be informative.

Autobiographical Memories for Very Negative Events: The Effects of Thinking about and Rating Memories.

In three related experiments, 250 participants rated properties of their autobiographical memory of a very negative event before and after writing about either their deepest thoughts and emotions of the event or a control topic. Levels of emotional intensity of the event, distress associated with the event, intrusive symptoms, and other phenomenological memory properties decreased over the course of the experiment, but did not differ by writing condition. We argue that the act of answering our extensive questions about a very negative event led to the decrease, thereby masking the effects of expressive writing. To show that the changes could not be explained by the mere passage of time, we replicated our findings in a fourth experiment in which all 208 participants nominated a very negative event, but only half the participants rated properties of their memory in the first session. Implications for reducing the effects of negative autobiographical memories are discussed.

“La littérature est la seule patrie”: Nabile Farès and the Poetry of Postcolonial Displacment

Nabile Farès is a key author within postcolonial studies, due in particular to his uniquely expressive writing style. This article discusses writing style in his 1982 text, L’état perdu: précédé du discours pratique de l’immigré. Throughout the mainly French text, different alphabets are woven, alluding to the complexity of Algerian linguistic history and the importance of language in the construction and expression of identity. Meanwhile, the grammar and structure of the French language seems confused and at times illogical, raising further questions about use of a colonial language in a postcolonial context. Farès’s writing style is avant-garde in nature, and deliberate intertextuality with the Surrealists situates the text within an avant-garde tradition in the French language, developing new ideas surrounding the effect of this written genre in the aftermath of colonialism.

Experimental induction of psychotherapeutically relevant emotional states

Background: Emotion research in neuroscience targets brain structures and processes involved in discrete emotion categories (e.g. anger, fear, sadness) or dimensions (e.g. valence, arousal, approach-avoidance), and usually relies on carefully controlled experimental paradigms with standardized and often simple emotion-eliciting stimuli like e.g. unpleasant pictures. Emotion research in clinical psychology and psychotherapy is often interested in very subtle differences between emotional states, e.g. differences within emotion categories (e.g. assertive, self-protecting vs. rejecting, protesting anger or specific grief vs. global sadness), and/or the biographical, social, situational, or motivational contexts of the emotional experience, which are desired to be minimized in experimental neuroscientific research. Objective: In order to facilitate the experimental and neurophysiological investigation of psychotherapeutically relevant emotional experiences, the present study aims at developing a priming procedure to induce specific, therapeutically and biographically relevant emotional states under controlled experimental conditions. Methodology: N = 50 participants who reported negative feelings towards another close person were randomly assigned to 2 different conditions. They fulfilled 2 different sentence completion tasks that were supposed to prime either ‘therapeutically productive’ or ‘therapeutically unproductive’ emotional states and completed an expressive writing task and several self-report measures of specific emotion-related constructs. The sentence completion task consisted in max. 22 sentence stems drawn from psychotherapy patients’ statements that have been shown to be typical for productive or unproductive therapy sessions. The subjects of the present study completed these sentence stems with regard to their own negative feelings towards the close person. Results: There were a substantial inter-individual variability concerning the number of completed sentences, and significant correlations between number of completed sentences and problem activation in both conditions. No differences were observed in general mood or problem activation between both groups after priming. Descriptively, there were differences between groups concerning emotion regulation aspects. Significant differences between groups in resolution of negative feelings towards the other person were found. Discussion: The results point in the expected direction, however the small sample sizes (after exclusion of several subjects) and low power hinder the detection of convincing significant effects. More data is needed in order to evaluate the efficacy of this emotional priming procedure.

Facilitating Emotional Processing: An Experimental Induction of Psychotherapeutically Relevant Affective States

Psychotherapy research has shown that cognitive-affective meaning making is related to beneficial therapy outcomes. This study explores the underlying micro-processes by inducing specific cognitive-affective states and studying their immediate effects on emotional activation, the resolution of interpersonal grievances, and factors related to therapeutic progress, e.g., mastery experiences, clarification of meaning. Participants suffering from interpersonal grievances were randomly assigned to two conditions. A sentence completion task was employed to induce either the expression of emotional distress or cognitive-affective meaning making. Expressive writing was used to deepen processing. Findings of those participants adhering to the induction procedure (n = 85) showed no differences between conditions at baseline. During writing, participants in both conditions were equally emotionally activated. Directly after the writing task, participants in the meaning making condition (n = 50) reported less unresolved interpersonal grievances, and more mastery experiences, but, e.g., not more clarification, compared to those in the emotional expression condition (n = 35). Results suggest that engagement in specific states that promote meaning making of emotional experience facilitates emotional processing and is related to therapeutic benefit.

L'impact de la création littéraire, en contexte d'aide, sur la symptomatologie psychophysiologique d'adolescents atteints d'une maladie chronique : étude interdisciplinaire et exploratoire.

Thèse réalisée dans le cadre d'un Ph.D.interdisciplinaire en Psychologie, en création littéraire et en orthopédagogie. L'impact de la création littéraire a été étudié chez des adolescents atteints d'une maladie chronique au CHU Sainte-Justine de Montréal. Cette recherche est exploratoire car la création littéraire n'a jamais été étudiée dans cette perspective. Elle a été réalisée sous la direction de Catherine Mavrikakis, professeure et écrivain à la Faculté des arts et sciences au Département des littératures francophones de l'Université de Montréal et de Jean-François Saucier, psychiatre et anthropologue à la Faculté de médecine au Département de psychiatrie de l'Université de Montréal et chercheur au CHU Sainte-Justine. Interdisciplinary Study.

Are Career Termination Concerns Only for Athletes? A Case Study of the Career Termination of an Elite Female Coach

This paper presents a case study of an elite female coach and her career termination from a 20+ year career following a critical life incident. A novel autobiographical approach was adopted whereby the participant undertook expressive writing to describe her experiences prior to, during, and following coaching an athlete at the 2012 Summer Olympic Games. Thematic analysis indicated seven phases related to the participant’s experiences of the critical incident: Build up to the event, the event, the aftermath, recovery and reflection on the event, sampling of new avenues, enlightenment, and career re-birth. The findings reinforce the high demands placed upon elite coaches, the subsequent threats to physical and mental well-being, and the importance of having robust psychological skills and suitable social support to cope with these demands. Implications for preparing and supporting coaches for successful career transition are discussed.

L'impact de la création littéraire, en contexte d'aide, sur la symptomatologie psychophysiologique d'adolescents atteints d'une maladie chronique : étude interdisciplinaire et exploratoire

Thèse réalisée dans le cadre d'un Ph.D.interdisciplinaire en Psychologie, en création littéraire et en orthopédagogie. L'impact de la création littéraire a été étudié chez des adolescents atteints d'une maladie chronique au CHU Sainte-Justine de Montréal. Cette recherche est exploratoire car la création littéraire n'a jamais été étudiée dans cette perspective. Elle a été réalisée sous la direction de Catherine Mavrikakis, professeure et écrivain à la Faculté des arts et sciences au Département des littératures francophones de l'Université de Montréal et de Jean-François Saucier, psychiatre et anthropologue à la Faculté de médecine au Département de psychiatrie de l'Université de Montréal et chercheur au CHU Sainte-Justine. Interdisciplinary Study.

The place of writing in first grade Kuwaiti english education : a sociological case study

A hybridized society, Kuwait meshes Islamic ideologies with western culture. Linguistically, English exists across both foreign language and second language nomenclatures in the country due to globalization and internationalization which has seen increasing use of English in Kuwait. Originally consisting of listening, speaking, reading and writing, the first grade English curriculum in Kuwait was narrowed in 2002 to focus only on the development of oral English skills, and to exclude writing. Since that time, both Kuwaiti teachers and parents have expressed dissatisfaction with this curriculum on the basis that this model disadvantages their children. In first grade however, the teaching of pre-writing has remained as part of the curriculum. This research analyses the parameters of English pre-writing and writing instruction in first grade in Kuwaiti classrooms, investigates first grade English pre-writing and writing teaching, and gathers insights from parents, teachers and students regarding the appropriateness of the current curriculum. Through interviews and classroom observations, and an analysis of curriculum documents, this case study found that the relationship between oral and written language is more complex than suggested by either the Kuwaiti curriculum reform, or international literature concerning the delayed teaching of writing. Intended curriculum integration across Kuwait subjects is also far more complex than first believed, due to a developmental mismatch between English pre-writing skills and Arabic language capabilities. Findings suggest an alternative approach to teaching writing may be more appropriate and more effective for first Grade students in the current Kuwait curriculum context. They contribute also to an emerging interest in the second and foreign language fields in the teaching of writing to young learners.

Addressing the needs of struggling literacy learners

Think back to your teaching experiences over the past four years. Were there a number of children or adolescents in your classes who seemed to have learning difficulties? What area of their learning seemed to be of greatest concern for these students? Did most of these struggling learners have difficulty with reading? Was expressing their thoughts in writing also a challenge? Did some of these students also have difficulty in listening to and following directions? And did some of these students seem hesitant when asked to speak to the class?

On this Writing : An Autotheoretic Account

An invited chapter that provides an autobiographical account of 'critical incidents' in becoming an academic writer.