Write your heart out!

This interesting randomized trial confirms what a lot of other research has shown: that people with all sorts of serious diseases feel better (and may even do better) when they express their strong feelings through writing. This study finding builds on a lot of prior research.

I've always felt that this is one of the unsung effects of cancer mailing lists like the BCMETS list (and bulletin boards and blogs, and of course journaling where people not only exchange information, but often write on a deep level of their experiences). Not only do people make contact with one another and feel less alone, and get good advice and information, but they have an opportunity to articlulate their deepest feelings.

Journal of Pain and Symptom Management, Volume 35, Issue 6, June 2008, Pages 623-631

Emotional Disclosure Through Patient Narrative May Improve Pain and Well-Being: Results of a Randomized Controlled Trial in Patients with Cancer Pain

M. Soledad Cepeda MD, PhD et al.

Narrative medicine is based upon physicians' awareness of patients' narration of their suffering, their hopes, and how illness has affected them. It offers a model for improving health outcomes.

To determine whether incorporating a narrative approach in patients with cancer decreases pain intensity and improves their global sense of well-being, we performed a randomized, single-blind controlled trial in adult patients with cancer and average pain intensity levels of at least 5/10.

Two hundred thirty-four patients were randomized into three groups: (1) narrative (n = 79), in which patients wrote a story about how cancer affected their lives for at least 20 minutes once a week for three weeks; (2) questionnaire (n = 77), in which patients filled out the McGill Pain Questionnaire; and (3) control (n = 78), in which patients came weekly to medical visits during which they received usual customary care. Patients rated their pain on a 0�10 scale and their well-being on a seven-point Likert scale weekly for eight weeks. Two raters independently evaluated the emotional content of the narratives.

Pain intensity and sense of well-being were similar in all groups before and after treatment.
Subgroup analyses showed that patients whose narratives had high emotional disclosure had significantly less pain and reported higher well-being scores than patients whose narratives were less emotional. Further study is needed to demonstrate whether the implementation of narrative medicine is associated with health benefits in this and other contexts.