Co-written with David B. Feldman, Ph.D.
Though Oxford Dictionaries and countless media outlets dubbed 2013 "the year of the selfie," the idea of putting yourself out there is nothing new. Since the 1990s, publishers have noted a steep rise in sales of personal memoir. In fact, in 2007, for the first time, publishers bought more memoirs than first fiction. Now that Twitter, Facebook and blogs have become commonplace, personal memoir -- once virtually the only way of laying oneself bare to the world -- is hardly the most prominent method. Critics have attributed this rise in self-focused expression to what psychologists Jean Twenge and W. Keith Campbell have called an epidemic of narcissism. "People are seduced by the increasing emphasis on material wealth, physical appearance, celebrity worship, and attention seeking," they write in their 2009 book, The Narcissism Epidemic. It's tempting to ascribe this trend to the base, and probably not very healthy, motives of vanity and self-absorption.
But what if there were another, healthier impulse at work, as well? What if there were some good to be found in our increasing desire to express our lives through stories and images? Perhaps there is something of real psychological importance here.
Pulitzer Prize Winner Adam Johnson Brings Trauma to Stanford
Writer and Stanford University Associate Professor Adam Johnson believes there is. Just prior to winning the Pulitzer Prize in 2013 for his novel The Orphan Master's Son, Johnson began teaching a literature class on what he called the "trauma narrative," a storytelling framework, he explains, that's often punctuated by fragmentation, broken chronology, changing perspectives, and holes. During the 10-week course, Johnson tasked his students with writing, and then rewriting, a true story about a single personal, somewhat painful event.
His original intention in offering the class was simple: he wanted to help students viscerally and personally connect with what makes books like Hemingway's The Sun Also Rises and F. Scott Fitzgerald's The Crack-Up powerfully special. Traditional narratives generally begin with a character who has a desire. The story flows from that character's choices and the conflicts that ensue relative to that desire. "But the trauma narrative is opposite," Johnson explains. "Instead of our hero moving toward achieving his desire, he's evading what's difficult to confront. He's constantly escaping what he doesn't want to deal with."
Johnson isn't a therapist, nor does he claim to be. Yet even to the untrained ear, this sounds a lot like psychotherapy. In fact, he says, he didn't fully anticipate the emotional impact the subject matter would have on the students in his seminar. "The class was turning in a way I wasn't quite prepared for, though I should have been," he says. "Something unique was happening to these students."
Johnson found that writers in his course began opening up to him and to themselves in profound ways. Some would cry. Others would reveal things through their work that they later would say they never imagined telling anyone. Perhaps this was just a side effect of asking students to think about their pasts.
Or maybe it was something more. Johnson wondered if there might be a more direct connection between writing personal stories and deep psychological healing.
Science Catches Up With Shakespeare
Writers have arguably understood on some level the psychological merit of writing about trauma as far back as the days of Shakespeare -- some theorists suggest the Bard penned Hamlet while recovering from the death of his 11-year-old son Hamnet. As it happens, psychologists also have long speculated about the power of writing. For about a century, it has been commonplace for counselors to ask their clients to keep journals, write letters to estranged or deceased loved ones, and otherwise put their thoughts into writing. Nonetheless, only during the past 25 years has science been brought to bear on these practices.
In 1986, James Pennebaker and Sandra Klihr Beall at Southern Methodist University conducted the first experimental study on what would come to be called the "writing cure." They asked 46 undergraduates to sit quietly in a lab room with pen and paper for 15 minutes a day, four days in a row. During those brief periods, they instructed some of the students to journal about their thoughts and feelings related to a personally upsetting experience from the recent past, while others wrote about superficial topics like the configuration of their living space. The results, published in the Journal of Abnormal Psychology, showed that students who wrote about their negative experiences were in better health several months later and had visited the campus health center significantly less than those who didn't write about their traumas.
As dramatic as these results may have been, they were hardly conclusive. The study only showed that expressive writing could improve short-term physical health. It wasn't very informative about longer-term health, let alone mental health. Besides, showing benefits in a small group of already healthy 18- to 24-year-olds is hardly a compelling demonstration of the healing power of writing. To impress anyone, researchers would have to show that expressive writing worked in much larger and more inclusive samples.
More than 200 studies later, they have.
By now, research has shown that expressive writing works for survivors of rape, recently unemployed professionals, HIV-positive individuals, prison inmates, spouses of post-deployment soldiers, and people with depression, among others. Depending on the study, it seems to improve mood, decrease insomnia, improve overall health, and even strengthen immune functioning. Though it's worth noting that not all studies have found positive effects for all types of problems, headlines such as "The Pen is Mightier than the Pill" have drawn significant public attention. Moreover, Stephen Lepore and Joshua Morrison Smyth's 2002 book, The Writing Cure, popularized the practice.
Perhaps these healing effects are part of why people feel drawn to write about their lives. Take the case of Helga Newmark, a bright, promising little girl born into an Orthodox Jewish family in 1930, only 10 years before Germany's invasion of Holland. The Nazis rounded up her family, sending them to the Theresienstadt concentration camp. Only Helga and her mother would survive, and Helga herself endured rape and starvation. The Russian liberation of Theresienstadt in 1945 brought freedom for her body, but her spirit, her trust in humanity, and her previously important faith in God seemingly didn't survive.
Nearly four decades later, driven by some innate self-healing impulse, Helga began to record her story in a journal. The prose initially was dark, the story disjointed and full of holes. Her entries reflected powerful, stark images and emotions. Of the camps, she wrote: "The noise, the smell, the vomit, urine and shit that has no place to go. Barbed wire fences, dogs barking, lice, beddings that itch, and darkness." But an odd thing happened as Helga continued to write. The narrative somehow became lighter. Her stories became clearer, with a stronger sense of time, place, context and purpose. The more Helga wrote, the more she seemed to gain perspective and a sense of control over her memories. In one of her entries, she wrote, "Holocaust has been, and is, a dominant force in my life, and even though I don't fully understand, I know there is, and was, a reason for our survival."
At least partly through her writings, she reclaimed a sense of meaning, and remarkably, of faith. And, at the age of 67, the Helga who once had completely lost her faith became the first female Holocaust survivor to be ordained a rabbi. Prior to her death in 2012, she published her writings in a volume called Letters to the Wise One. The book chronicles her time in the camps and her lifelong quest to recover some of what had been lost.
All this makes expressive writing sound almost magical. And this poses a problem: Like magic, nobody knows exactly how or why it works.
It Works! But No One Knows Exactly Why
Some researchers and clinicians believe expressive writing helps to release pent-up emotions that otherwise might fester, leading to psychologically poisonous effects. Others think it works through encouraging cognitive processing, creating an opportunity for people to label, structure and organize their traumatic experiences in a new way. Still others believe it functions through simple exposure -- by repeatedly confronting painful memories, people may get used to them, causing those memories to lose their emotional power, much like confronting heights, dogs or flying helps people to overcome phobias.
The jury also is out on whether expressive writing is equally effective when done online, for all to see. Most writing studies have involved people literally penning their trauma narratives, though a few studies show that expressive writing can also work when done via email and long-form blogs. The picture is less clear when it comes to Facebook and other social networking sites, where factors such as number of friends or followers, perceptions of social support, and user comments may be important. Also, not everyone uses these services to post narratives. Sometimes people simply upload photos of what they ate for lunch.
And then there are the questions Adam Johnson was left with after teaching his course. "Telling a trauma narrative is therapeutic for anyone who has a traumatic story to tell," he speculates, "even if they tell it in traditional fiction." Many of his students fictionalized their stories, adding and subtracting details, altering characters or changing settings. Even after authoring a fictional version of their story, however, students would often tell him, "This is the first time I have really talked about this. This is the first time that I perceive that others understand me." So, it's worth wondering whether writing fiction may also be therapeutic.
And what about the students in similar classes who write about the traumatic experiences of their family members, friends and others, rather than about their own experiences? "A lot of the trauma narratives I read are written by people who are going out to China, Korea and the Congo, bringing a microphone and saying, 'I care about your story, let me help you tell it,'" he says. In these cases, Johnson wonders if some therapeutic benefit is passed on to the reporters, too.
It turns out that their observations mirror the science. Consider the curious findings of a study by Melanie Greenberg, Camille Wortman, and Arthur Stone, researchers at the State University of New York at Stony Brook, which showed that people who wrote about someone else's trauma appeared to experience physical health benefits similar to those who wrote about their own traumas, or psychologist Laura King's research demonstrating that writing about personal goals, and not traumas at all, leads to similar benefits.
These benefits may not be solely for the writers and reporters, explains Maria Hummel, a lecturer who, like Johnson, leads a trauma narrative-style course at Stanford University. Hummel, author of the poetry collection House and Fire, has found that many of those who have enrolled in her class are not literature students at all. "The biggest proportion want to go into a health related field," she says. "They want to be the most well-rounded doctors they can be, so they invest in the humanities side of medicine."
Since the 1990s, medical practices have begun to structure themselves much more around the patient narrative. The theory, says Hummel, is that by listening to patient stories, practitioners encourage empathy and promote understanding between clinician and patient. Though perhaps not the norm yet, this use of narrative in medicine has become an increasingly more concrete part of the medical establishment, where doctors learn not only to treat the symptoms, but the whole person.
Ultimately, what started for Adam Johnson as a technique-building class for students interested in sharpening their skills in telling hard stories became something far more profound. Johnson took a hiatus from teaching the course in 2012 to accommodate a book tour and a busy schedule of speeches on trauma narrative and other topics. After these talks, sometimes attendees approach him, affected by the traumatic themes he writes about. They ask him to sign their books and then tell him about the horrible traumas they've suffered in their lives. This reaction fuels Johnson's conviction that writing about one's life, perhaps particularly the worst parts of it, can be healing.
Narcissism aside, there may be some very good reasons for people's natural urge to tell their personal stories.
Lee Daniel Kravetz and David B. Feldman are the authors of Supersurvivors: The Surprising Link Between Suffering and Success, released by HarperCollins/HarperWave (July 1, 2014.) For more information, visit www.facebook.com/SupersurvivorsTheBook or www.supersurvivors.com