So let it be written, so let it be done: The Creation and Importance of Writing Trauma Narratives
Learning how to write is essential for being able to communicate with the world around us. But exactly how essential is writing in helping us communicate with ourselves? Effective writers are able to put thoughts into words and create a narrative that makes sense to others. Similarly, good writers are able to clarify thoughts so that they make sense to themselves. There is something innate about the physical act of writing that brings serenity and connection. Why is there such a feeling of closure, especially for survivors of trauma, once something has been written? Art Markman, a cognitive scientist at the University of Texas says, “The benefit [of writing about trauma] is in creating a story that links together emotional memories. Making these traumatic events more coherent makes memories of these events less likely to be repeatedly called to mind, and so they can be laid to rest” (para. 7, 2009). For the purpose of this discussion, I will be referring to trauma as defined by the Diagnostic and Statistical Manual of Mental Disorders (or the DMS-5) as: “Exposure to actual or threatened death, serious injury, or sexual violence” (American Psychiatric Association, p. 271, 2013). In this paper, I will discuss expressive writing as a coping mechanism, and I will explore how and why the use of expressive writing to create a trauma narrative provides closure, distance, and safety in recovery.
The Healing Power of Telling the Story
For a person reliving trauma, intrusive thought recall leads to stress and discomfort because the person relives the events in ways that are fragmented and confusing. But there is a healing power behind experience focused writing. Using expressive writing, a person is able to create a full narrative, paying close attention to detail in putting an end to their story. Clients can also edit the story as new details surface and memories come to focus.
The interesting piece about trauma and post-traumatic stress symptoms, is unlike other anxiety disorders, there was the experience of an event that was traumatizing. The distinction was further identified with the reclassification of PTSD, or Post Traumatic Stress Disorder, as an Anxiety Disorder in the DSM – 4 and into the new Trauma and Stressor-Related Disorders class of the DSM – 5. Specifically, in trauma treatment it is important for the client to realize the traumatic event that took place is never going away. Treatment cannot involve a cure, since the past cannot be changed. Treatment can, however, work on the current symptoms, using techniques to lessen and control distress.
The continued use of techniques outside of a controlled environment or counselling sessions is the goal. Clients are able to move forward when they face their symptoms in their daily lives. This is crucial to journeys of recovery, because sometimes the effects of trauma or post-traumatic stress do not go away. Expressive writing can be used as both a coping mechanism and a form of continued self-care easily, as writing does not require constant professional guidance. Writing things down is suggested as a calm, non-physical activity that helps with recall and attention. Having a narrative allows the person to go back and add feelings, as well as move forward from it remembering where those feelings stem from.
History of Writing as Therapeutic
Expressive writing is a form of informal writing, that often appears as diaries or journals. Using writing as a coping mechanism seems to work because it provides space and distance from what is written to allow clients to physically separate their thoughts from themselves. Many effective coping skills for post-traumatic stress symptoms are types of grounding techniques, which are meant to help control symptoms by refocusing attention to the present moment and surroundings, forcing the mind away from distressing thoughts.
It can be difficult to write or get into a space where words flow if a person is distracted, unfocused, or not directly present. The act of writing requires a person to be present, grounded, and mindful. Thinking back to elementary school, my teachers gave students time to journal, usually at the beginning of the day or after recess. I speculate that this activity was intended for literacy, but also a great technique to get 30 school-age children to calm down, sit still, and be quiet.
Counsellors and social workers use writing themselves as a form of reflexive practice and self-care daily. Such practices help workers avoid burnout, compassion fatigue, and help with their own mental wellness. The importance of practicing self-care is driven into social work and mental health students from day one. So it makes sense that this reflexive practice is helpful for clients as well. Clients with trauma are experiencing burnout from their own thoughts, flashbacks and demons. Citing multiple studies, Nevine Sultan, PhD of Counselling Education and Supervision, points out that “written self-disclosure about trauma or stress can enhance positive self-perception, which may result in higher self-concept” (p. 78, 2018). Clients writing what they are experiencing, what they are feeling, and what they think about the situations that provoked the thoughts, can help with understanding recall of emotional memories and trigger recognition.
Neuropsychology: How Trauma Memories are Saved
Much research has been conducted exploring the differences between trauma memories and autobiographical memories. Autobiographical memories are comprised of specific, personal events, where the “who, what, when, where, and why” can be easily recalled. These memories differ from memories of trauma in several ways: autobiographical memories are “time stamped,” episodic, and created in everyday situations and normal brain function. With trauma memories, Psychologists, Nadel and Jacobs (1998), explain that stress levels impact the function of certain parts of the brain that work to create and store memories. The authors state “when stress is high enough to impair the function of the hippocampus, resulting memories will be different from those formed under normal circumstances.” The hippocampus, when compromised by high levels of stress, results in other parts of the brain, mainly the amygdala, to be enhanced by this same stress. The amygdala creates and stores memories in these situations, but is only able to record emotional memories, and this is why as Nadel and Jacobs state, that “memories of trauma may [only] be available as isolated fragments rather than as coherently bound episodes” (p. 156). For example, the memories of a child being bitten by a dog would likely be recorded and stored by the amygdala. What will be made into a memory, is the feelings of fear and pain from the event, and that the dog was the danger. This trauma memory may not include who else was around, or when and where the event took place.
Nadel and Jacobs go on to explain that even when there is a complete lapse in autobiographical memories, the intrusive and emotional remnants of the trauma are often triggered to mind. Remnants are disturbing, anxiety provoking, and typically lead to hyper-vigilance and perceived threat despite no basis in reality. The differences in creation and storage of memories are important when discussing the needs of those seeking trauma treatment and recovery.
Nadel and Jacobs share research from Van der Kolk and Fisler (1995), who explain “that after an initial phase when traumatic memories are experienced as fragmentary, an autobiographical memory eventually emerges” (p. 156). This research explains that after some time, the mind either remembers an increased number of fragmented memories, forms imagined conclusions, or both. When expressive writing is used as a coping mechanism, the writing can help create a narrative that links together these emotional fragments into a coherent and conceivable autobiographical episode. Writing helps the client identify and give meaning to emotional fragments, all the while challenging narrative fallacy.
Appeal to Authority
Research proves that parts of the brain shut down when experiencing trauma. Psychiatrist, Bessel Van der Kolk, MD, explains in his book “The Body Keeps the Score,” that “scans showed that Broca’s area went offline whenever a flashback was triggered.” He continues “without a functioning Broca’s area, you cannot put your thoughts and feelings into [speech]” (p. 43, 2014). Where the verbal fails, writing can be used as a way to ground, avoid, and subside a flashback, keeping individuals mindful of the moment. Van der Kolk discusses how survivors often come up with a verbal “cover story” (p. 43, 2014) to tell others about their trauma. However, he states that these stories do no justice to the reality of their experiences, but writing their story out potentially can.
There is a large amount of research exploring trauma treatment and trauma memories, and there is separate research about the educational benefits of writing, but there is gap in research connecting these two fields. We know that recovery from trauma often comes with telling one’s story and that journaling is an effective coping skill. What is still to be determined is why the act of writing is such an effective coping mechanism, especially for trauma. I speculate that the act of writing sparks a reaction in the brain to focus a person’s attention to the task and words at hand. I would argue that having a physical distance from one’s narrative provides security as it becomes only part of their story. Perhaps writing breaks the shutdown of Broca’s area when triggered by trauma and overhauled by a person’s learned ability to write. We know for sure that writing is a helpful coping mechanism for trauma, but research is lacking as to why.
CBT and Trauma recovery Strategies
Another form of trauma treatment that often involves writing, is Cognitive Behavioural Therapy (or CBT). This is a form of psychotherapy that is typically short-term, solution focused, and goal oriented. The goals of CBT are to challenge and change patterns of thinking and/or behaviours that have significant and negative impacts on daily living, such as post-traumatic stress symptoms. CBT includes counsellor or therapist interaction, coupled with take home interventions like writing down distressing thoughts and feelings, then challenging them with evidence-based rational thoughts. Expressive writing, journaling, and dairy keeping creates a narrative that includes facts of what happened, while tying in the emotional links. The act of writing provides privacy from judgmental eyes and avoids the intolerable silent reply of another. In this self-care style of writing, clients are empowered to direct their own emotional experience aimed at describing their trauma.
Using Expressive Writing to Make Better Writers
In treatment or therapy, clients may be taught expressive writing as a coping tool. Meanwhile, outside the context of therapy, expressive writing is taught to develop fluency, chronology, and tone. A study by Timmermans and Johnson (2017) shares the experience of teaching poetry in a second-grade class. Johnson paired students, so they could discuss their analysis of a poem, and she gives an example of a poem about colour. She states, “through conversation, they can more easily connect colour to the sensory experience and consolidate their understanding of how poetry serves as a means of expression” (p. 358, 2017). Through reading and discussing forms of expressive writing, children learn to connect with their experience with the material and entrench their understanding. Having children write in these many forms of expressive writing not only teaches them how to write in form, but also how to choose meaningful words, and write in a way that will connect with others and themselves. Clients can also use these basics to learn how to write their own trauma narrative in a way that connects their experience with powerful words, that will effectively be significant to themselves and others.
Conclusion
The goal of trauma treatment is to give the client the tools, knowledge and coping mechanisms to feel empowered and be able to manage physical and psychological responses to trauma and triggers. The act of writing serves education and trauma recovery. Expressive writing is a form of catharsis, and a narrative is a story the client no longer has to carry.
Currently, I am a student in the social work program, but I also work as a crisis worker, and a frontline worker in a shelter for women and children fleeing domestic violence. I see how trauma affects people every single day. Often, my job is to help individuals struggling with the distress and consequences of post-traumatic stress symptoms. Trauma can be debilitating. Fragmented intrusive thoughts, brought on by potentially anything or any situation, can make daily life a constant battle, and in some cases parallel with a battle against abusers.
I suggest writing a trauma narrative could be the second step in treatment. Further research could consider trauma therapy as a 3-step strategy that begins with CBT and other psycho-education of here-and-now coping strategies, followed by writing a trauma narrative, and finally, using talk therapy that includes narrative sharing and revision. This idea is in the beginning stages, but may help a move forward in treatment for survivors. There may also be further research implications once we better understand why writing works so well. But for now, there is nothing wrong with survivors taking back their power through writing because it works.
References
American Psychiatric Association. (2013). Trauma and Stressor-Related Disorders. In Diagnostic and Statistical Manual of Mental Disorders (5th ed.), 271-280. Washington, DC: American Psychiatric Publishing.
Markman, A. (2009). Trauma and the Benefits of Writing About it. Psychology Today. Retrieved on January 21, 2019 from https://www.psychologytoday.com/ca/blog/ulterior-motives/200910/trauma-and-the-benefits-writing-about-it
Sultan, N. (2018). Embodied Self-Care: Enhancing Awareness and Acceptance Through Mindfulness-Oriented Expressive Writing Self-Disclosure. Journal of Creativity in Mental Health, 13(1), 76–91.
Nadel, L., & Jacobs, W. J. (1998). Traumatic Memory Is Special. Current Directions in Psychological Science, 7(5), 154–157.
Timmermans, K. M., & Johnson, A. (2017). Introducing and Sustaining Close Reading and Writing Through Poetry. Reading Teacher, 71(3), 357–362.
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.
