The Science of Journaling: How 15 Minutes of Writing Can Free Up Your Brain, Improve Your Health, and Make You a Better Friend | Dr. James Pennebaker

30:04But coming back to that in a second, the first part of what you were saying, Dan, about narrative medicine, that's a really, I think, really important feature that is probably not focused on enough within medical training because it really brings you to the bedside next to the human being. And it's about not only the patients being able to express themselves and what they're experiencing, and as the provider, you being able to better understand who they are, but also as a provider, there's lots to write about where you can certainly then discover not only what your issues are that may or may not help you help somebody else, but really just helps you be in the moment and benefit your patient as much as possible because of this connection and deep understanding.

30:55Now, nobody shows up in an exam room with a piece of writing to hand to their clinician and vice versa. But in essence, that's sort of what we would like to have what's on the other end of that. And that would take time and conversation, which most clinicians don't have. So the narrative medicine, I took a course in it, not a master's degree, which does exist. And there's a great one through Columbia University, is really about not only practicing writing, but practicing reading other narratives and really getting into what people are saying and how they are saying it, which I think Dr. Pennebaker probably has something to say about as well.

31:40I have spent some time with people in the narrative medicine world, and I've been impressed with their emphasis a lot on literature in terms of reading stories of illness and healing in classic literature as well as other kinds of narrative. and I think it has real strength to do just what you're saying is making a physician more aware of the person and the context of their illness and what I would love to see more of in medicine and in psychotherapy as well is trying to understand to appreciate that illness does not occur in a vacuum. This is, you know, dealing with relatives who have been having health problems.

32:29I'm fascinated that the kidney doctor just looks at the kidney and ignores the rest of the body. And the lung doctor looks at that and nothing else. And nobody ever says, well, what's going on in the person's life? That, you know, we think of the old family doctor, you know, who went around with a little black bag as a true holistic medicine expert. But our training is so specialized now that we just don't do that. And I do think trying to understand the context, the life context of what's going on with a person is so important. But again, the economic models of medicine now don't allow it. That's true.

33:12Really what resources are being poured into is dealing with the burnout and the fallout of not doing those things, which actually does involve writing. The other thing you said earlier, Bianca, that I don't want to get lost in this discussion is you honed right in on whether the story should be accurate. And I just I think that's a really interesting question. I understood Dr. Pennebaker's answer, which was, you know, I'm not dismissing the value of accuracy, but the real point of this exercise is a kind of a purge, getting it out there and making some sense of it. But I just wanted to make sure I didn't, that I gave you a chance to come back to this if it was something you wanted to say more about.

33:53If I could just bring up something about the metaphor you implied. I don't view expressive writing as a purge at all. I don't view it as allowing the pot to boil over, you know, to let all the emotions out. I view this as a much more cognitive process. That is, it's a quest for self-knowledge, self-understanding. Why am I feeling this way? So at the end, you walk away with greater insight in terms of why you've been so upset about this experience, why you've been obsessing about it, because you really need to understand what's happening. It's not that you're flushing the emotions away. It's not that you're purging anything.

34:37You have come to a new understanding of your situation, why you did what you did, why the other people did what they did, and also ways of how do I move forward from here. So it's not a purge, it's a shift of perspective. And a new understanding, right. I think that all sounds just right. And the partner to that, which I think comes through writing around illness and going back to narrative medicine is that so much of trauma is locked in the body. So they may be secrets that you don't even know that you have cognitively. And when you start writing about things that you actually physically feel, whether you're distressed or not, or you relate to an illness and start exploring that, there's a whole other world of experiences that you may not have tapped into that also shape how we think.

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39:55But Bianca, just go back to accuracy, because that feels like something that's maybe worth running down. I know for me, so many of the stories I'm telling myself benefit from some fact checking, from some mechanism to call bullshit on them, either through talking about it with somebody else or viewing them, you know, shifting my perspective internally. So I just want I don't want to let that pass. If you know where I'm going with this. I don't know if it's about fact checking, because I think the experience is the experience. Sometimes perhaps something was said that we don't remember or vice versa.

40:35It's more the interpretation of it and the putting together of facts in a particular order. and for me the writing is very much integrated with the talking and so there is an ongoing conversation with my therapist not after every writing of course but sometimes it does take somebody else seeing it I think you have to sort of graduate to that point but in a safe space being able to feedback what they've heard versus what you've been saying what they maybe know about you now versus the story you've told yourself from 30 years ago. Because no matter how healed you think you may be, there's always more to learn.

41:18You don't have to learn it all. But I think two things can happen. One, again, a therapist or a friend or some safe person that has, without judgment and with great care, held some of your secrets and pain for you and is able to circle back with things that help either validate or reshape what you have told yourself if it's not beneficial. Also, sometimes going back to the players and as a mature adult versus a little kid, you know, going to a mom or a sister or whomever and saying, hey, is this what you experienced? I am revisiting several of those things right now. And it's fascinating because one of the main things that comes out of trauma therapy in particular that I feel super excited about is that once you really unearth your negative memories, there's a whole boatload of positive that you've suppressed with it, even within the moment of trauma, or maybe not the exact moment, but within that time frame.

42:25and you can't access those. Huge swaths of your life have been totally overshadowed by short moments, not to minimize those moments again. But part of retelling the story, reframing the story and taking from it is recognizing that, oh, that year wasn't all shit. You know, there's a lot that happened that is still true and real and impacted me in a way that I can use now. Dr. Penderbaker, I know that, or I believe I know that one of the benefits that you've found among the folks that you've studied who have done expressive writing, which again is your journaling protocol, you see social changes, that they're more likely to talk to their friends about their stuff and they're increasing their social engagement generally.

43:12Am I stating that accurately? That's correct. It's been very Interesting. Years ago, I worked with a very interesting project when I was in Dallas, interviewing people who had survived the Holocaust. And they had been generally in concentration camps in World War II. they had moved to dallas these people now were had kids and i did surveys before we did these interviews with the survivors and the majority of people had not talked to other people in any detail about their holocaust experiences and this was part of a an archive project where we people came into a television studio and we interviewed them and then we gave them a copy of their videos.

44:01And then I contact them again several weeks later. And the average person now had shown the video of their testimony to at least 10 other people. And they now were talking about it and they never had because they were afraid that other people would be too distressed by it. And I found this over and over again in our studies that after writing about an upsetting experience people are much more likely to talk about that experience with others and also the studies that we did this is some other projects what we would do is we'd ask people to wear a little tape recorder and it had there would have a lapel mic and it would the recorder would come on for 30 seconds and go off for several minutes and then come on again they never knew when it was on and off.

44:54And we'd ask them to wear this for two days in the week before their writing, and then again about a month later. And what we found was that people on questionnaires would say, well, you know, this study didn't affect my social behavior at all. But in fact, it did. The month afterwards, they were talking more with others. They were laughing more. They were using more positive emotion language. They were better friends. They could listen to others. They could respond in ways that they couldn't do prior to the writing. And I think part of this goes to some research that was done showing that people who do this expressive writing, they have more, it's called working memory.

45:40They think better. They're able to remember things better. They have more capacity, if you like, because they're not worrying about the things they were worried about before the experiment. That is so interesting that if something is bothering you, whether it's a secret trauma or a sort of more mundane vexation, it's taking up bandwidth that once you write it down, process it, get a greater understanding of it. I know you don't like purging, but let's just say unburdening yourself to a certain extent, then actually you you have access to parts of your brain that were previously being chewed up by this noise.

46:23That's exactly right. And actually, the first study that did this was looking at the college freshmen during their first weeks of college. You know, if you think back to when you get a new job, you start college, you start anything, those first few weeks are overwhelming. And you're, am I doing the right thing? How do I negotiate this new life? And by writing about it, It helps to simplify it, to organize it. And now you don't need to obsess as much as you have. I'm not a psychiatrist, but I do recall, I think, that there's something called pseudodementia that goes with depression and or anxiety.

47:04And it really is this sense of having your brain co-opted when it's dealing with intense emotion or secrets or something else. and things as basic as word finding and certainly memory issues. And they can be very scary when they present, but that's real. Yeah, no, this is a very real, we all get stupid when we're under a lot of stress. And this has been shown over and over and over again. That's a great quote. I'm writing it down. I'm going to use it first. Don't be surprised if you see that on my Instagram sometimes. but I'll give you credit. You've done decades of studies on expressive writing.

47:48What other benefits have you seen showing up physiologically and psychologically for people? It's a very, very long list. And I'm very serious. There have been over 2 ,000 studies done on expressive writing. It's been shown to be related to how long people are in the hospital after surgery. It's associated with wound healing. It's associated with changes in various markers of immune function, kidney function, other kinds of biological markers. It's associated with absenteeism from work. It's associated with reduction in insurance costs. It's associated with better social lives afterwards. It helps people stop smoking, stop drinking.

48:31It helps them, And, you know, almost anything in life that you find yourself obsessing about or worrying about, it helps to organize them. People do better on standardized tests like the MCAT or SATs or GREs if they write about their stress, their issues in the days and weeks beforehand. In other words, any place where your mind is overactive, you're ruminating too much, writing can be beneficial. I've also read that it helps with sleep. It helps with sleep, so people sleep better after writing. If people are interested in trying to find out, can this work with this particular problem, go to Google Scholar and enter expressive writing and fill in the blank.

49:21And there's probably been a study done on it. Yeah, I mean, I've heard about it helping with autoimmune disorders, with decision making, with anxiety, lots of stuff. Yeah, and chronic pain is one area that there's been some really fascinating research done where it's associated with reduction in chronic pain, PTSD. You know, some of these big issues that we deal with in the mental health world and physical health world. And also, let me just stop for a second. This is not a panacea. Don't expect you write for three times and then all of a sudden you're going to win the lottery. Life will be beautiful.

50:03The people you have wronged in the past will come and beg to be friends with you again. No, it helps sometimes, but this is not a panacea. I have two questions. One is, and I grant you that these studies are probably pretty hard to do in terms of really in the randomized components, having, you know, samples that are truly randomized versus how are we controlling for mental health disorders and other things that might sway one way or the other. But generally speaking, are there any background mental health issues that either benefit more or perhaps should not be done in solitary, I guess? If somebody is deeply clinically depressed, I'm not sure that expressive writing is the first method I would recommend.

50:57if you've just had a massive horrible trauma i don't think writing is necessarily beneficial and if you're if you happen to be a therapist i would never ask somebody who's just gone through a major trauma to to push them to write about it at the time if they want to that's great but i think people are particularly vulnerable in the aftermath of a major traumatic experience i I generally think that people benefit most when they find themselves thinking about something too much. And if you've had a major trauma and you're thinking about it all the time yesterday, you're not thinking about it too much.

51:40That's normal. But if you're thinking about it all the time six months later, that's too much. So that would be my primary recommendation with not to write. And also, if you start writing and you don't feel better, if you don't feel so this is being beneficial, this might not be a good time to write as well. In terms of are there particular places where it is beneficial, you have to be your own researcher here. In other words, try it. Think about it. There's no downside. It's free. I'm not going to ask you to send me$50 because I came up with the idea and I patented it. It's not patented. Nobody patented the idea.

52:28And you can throw away what you've written. Nobody needs to see it and probably shouldn't see it. So try it. And that's what I like about it. There's no significant downside that I can see. it's interesting too what you say about doing it for you because just makes me think about you know admissions essays to medical school to colleges and how really it's become about proving that you've been through something and that you've overcome or perhaps you haven't but you're able to disclose more about it and for some people that really works but for others and i think for minorities in general from what i've read about that can be distressing if it's something that is expected to be brought forward and yet it's being relived and almost objectified in a way as a measure of your worth to an academic endeavor.

53:27So, yeah, I think really writing about it for yourself is an important note. That's exactly right. I know you all are thinking about some kind of writing exercise on your website. And the primary issue is, I would urge people when they do this, is that this writing is for you and you alone, that unless they somehow specify it, there's no feedback that this is something that is something that just gives them the freedom to write. You know, and there can be prompts as well. Questions such as, in writing about this, how might it be related to your family? How does this affect how you are getting along with others?

54:19Or how is this affecting your health? Or things like that. So you could have prompts. There's so many ways you can set it up. But the essence is giving people the opportunity to put this issue into words, ideally one that they've not spoken to other people about in general and letting them come up with their own kind of understanding of the experience. I believe there's been some research on gratitude lists. Is that something you've looked into as well? I have not. I don't know the literature on it. And again, I believe in trying everything. It's really important. There is not a true way. And so try gratitude lists.

55:06And if you feel better, if you feel so it makes a difference, fabulous. Keep doing it. So I think that's the most important issue. I'm not selling a panacea and nobody is selling a panacea. All of us need to, if you are suffering, to try to figure out what works best for you. Yeah. Yes. Yes. Just to emphasize, you're in a welcoming place for people who are allergic to panaceas, given the name of this show is 10 percent happier. So we're not about miracle cures here. Just to say on gratitude, I've done a little bit of looking at that. And it does appear there. It does appear that there are some benefits to that.

55:49There are a couple of other ways that I have found journaling to be helpful. One, there appears to be some literature on the other. I haven't seen anything. One is that the sort of making and remaking of to do lists. Apparently, I find it very helpful in terms of setting my priorities and helping me make better decisions. And it reduces it helps my working memory because I'm I've got it all in one place and I can then focus on what I need to do. And that appears to be backed by some data. And then the other thing I use journal for is when I'm in conversations, in fact, I'm doing it in this conversation.

56:25I'm taking a lot of notes, especially about things I want to say so that I don't forget what I want to say, but I also don't jump in and interrupt somebody else and cut them off. So any thoughts on either or both of those? Since I hardly do any to-do lists, I don't approve of them.

56:45But sure. They're helpful to do them. And I do, when I'm under stress, when I'm about to move, there are certain times I actually do to-do lists myself. And I do think they do exactly what you're saying. They are helping your working memory so you don't have to keep thinking about it. Those thoughts now are transferred to a piece of paper. So that paper is having to do all the work. So in that sense, yeah, that makes good sense to me. So I get anything that we do that you feel is beneficial. Do it. I've been very open about the fact that I come by my specific money neuroses, honestly. So I've found some tools that have really helped me reorient to my personal finances in a healthier and sane way.

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59:29And this, from a scientific perspective, is horrible because we want a nice, simple explanation. What I've come to appreciate over the years is it's really a whole cascade of things. When you sit down to write about an upsetting experience, ideally one that you have not spoken to other people about, the first thing you're doing is acknowledging it has happened. So that's the first issue. The second is you're putting it into words. When you put something into words, you are changing the way that it's organized in your mind. And we know this from research on eyewitness identification and many other places in psychology.

1:00:08Putting something into word really does simplify it in our minds. And it simplifies it in a way that it also distorts things because now it's simpler than it actually was when we experienced it. The next thing is once you've put it into words, you have to impose structure on it. even putting it into a sentence requires that there's a beginning middle and end of that sentence and your next sentence almost innately follows from the first sentence in other words when you you know you've had an upsetting experience and you're walking down the street you think about this part of it you think oh i should have done this and then you start thinking about something else and you think about that but you're not bringing it all together and what writing is doing is forcing structure, is forcing you to see things from a broader perspective.

1:01:02And then it, and all of this is effectively giving it some meaning, which means now that we don't have to obsess about it or ruminate about it the way that we had been in the past, which means we sleep better. And we know that sleep is associated with more efficient immune function. It's associated with improved working memory, drops in depression, all of these other markers, which is also associated with changes in our eating behavior. So all of these things are related with the changes in social behavior. It allows us to be better friends so we can listen to other people better and we are more socially connected.

1:01:44So it's a mixture of all of these. And we could also, if we wanted to go in the direction of the brain, there's been research showing there are brain changes and there's all sorts of changes in autonomic nervous system and immune function systems. So all of these systems are interconnected. So that's on one level not a very satisfying mechanism. But the reality is, is when we're dealing with people dealing with major upsetting experiences, their entire lives have been disrupted. their eating patterns, their connections with others, their work life, their home life, everything. And so it's not surprising that writing is one strategy that can help to help align all of these changes that have occurred.

1:02:34So mechanistically, it might be very, very generally speaking that it's really a modulation of the stress response that then impacts all these other pathways, even changes in the brain? Yes, but then someone could say, well, it's the changes in the brain that's modulating all these other responses. And then other people say, oh no, it's changing their social behavior, which changes their brain, which changes. So all of these, I mean, that's what's so interesting. These are all so horribly interconnected. That's the problem of being a human. Or actually being a primate. Actually even being more than a single-celled animal.

1:03:17And even... I'm picturing Iguazu Falls in Brazil, where Bianca and I just went with our son. You know, it's just these series of interconnected cascades. And that's coming to mind as you're talking about the benefits here. That's right. Now, that's a metaphor. I can work with that.

1:03:39we're kind of rounding third here into the uh into the final section of our of our time together but before i let you go in in preparing us to do this interview our producer marissa schneiderman who's uh who's running point on this episode she every time we do an episode one of the producers in this case marissa gives me or me and bianca a prep doc and in marissa's prep doc there was a section where she talked about another, and I think maybe related field of study that you've engaged yourself in, which is the psychology of word choice. And so I thought before we let you go, I'd invite you to say a few words about that.

1:04:18So fortunately, we've got another two hours to talk. So I, the expressive writing research, the first paper came out in 1986. And in the next few years, more and more studies started to show that it was beneficial. And it led me to, and others, to ask the question of why does writing work? And one of the issues I became interested in was maybe we could get a better sense of how people benefit by looking at their actual writing samples. And maybe if I analyzed their writing samples, I'd have a better sense of how they were changing in their thinking. I gave these samples to clinical graduate students and had them rate them along multiple dimensions, which turned out to not work very well.

1:05:08The people didn't agree on the dimensions and there were similar problems. And I thought, well, you know, maybe I could just get a computer to analyze this data. However, to analyze the words, and as had happened, I couldn't find any. So I ended up working with one of my graduate students at the time, Martha Francis, and she and I put together a computer program that would go through and analyze text and calculate the percentage of words in the text that were, say, positive emotions or negative emotions or different kinds of cognitive styles, the way people were thinking. And we also looked at other parts of speech, you know, pronouns and prepositions and so forth.

1:05:52And the computer program ended up giving us some insight that, in fact, that people who benefited the most tended to use more positive emotion words in their writing, which might get back to the gratitude issues. But what was even more potent was the people who tended to change and increase in their use of cognitive words. These cognitive words could be causal words, words like because, cause, effect, you know, for people trying to understand the cause and effect of issues. or inside words, words like understand, realize, know, that people who increased in their use of those words benefited more than people who didn't.

1:06:32And this started to get me to think about how we can look at thinking patterns and other psychological patterns in language. And one of the things that popped out also was that we discovered that people who benefited the most, Some days would use I words, I, me, and my words at high rates. And on other days, they might use words like he, she, we, you at high rates. Almost as though they were changing perspectives from day to day. And the people who wrote in the same style did not benefit. And this led me to the last 20 years, 30 years of research, focusing on what we can learn about ourselves and about people in general by the way they use words.

1:07:25So, for example, we can see personality differences in the way people use words. A good example might be of the people listening to this podcast. if we went in and analyzed all of your text messages or all of your emails over the last few months, I could immediately tell which people are really sociable and which ones aren't simply by looking at third-person pronouns, he, she, they, or maybe words like we, that people interested in other people make references to other people. There's a big shock. But what's interesting about this is there are these little words that none of us ever pay attention to that tell us about others.

1:08:12And that is where I've gone in the last several years. And it's relevant to our ability to see how people think. So we've done research in terms of with Reddit, looking at how the pandemic affected the culture and how it has changed the way that we have thought over the the last three or four years. And we can get, we can look at differences in cities and age, sex, social class, et cetera. It's a really interesting marker of people's kind of psychological lives as it's revealed through language. Are there practical takeaways based on this area of your research vis-a-vis the first area, which is journaling?

1:08:57In other words, can we look back over what we've written and use the lens that you just described to help us improve in any way? A little bit. Keep in mind that language reflects our psychological state. It doesn't drive our psychological state. In other words, we've done studies where we tell people, okay, I want you to write this using this kind of language. And they can do it, but they don't benefit more than otherwise. But one thing you can look at, you can look at your own emails or text messages over time and you'll see certain things. So for example, people who are depressed or they're heading into a depression, they're shifting their language some.

1:09:45And one of the best markers is the use of these I words, I, me, and my. When people are depressed, they use I words at higher rates than when they're not depressed. And people who are bipolar, who often fluctuate between manic and depressive periods, there have been some interesting Twitter studies showing that in the weeks before they are full-blown depressed, you see this increased use of i words that is a kind of a leading indicator of psychological state now that the differences are subtle and a person might not see it themselves a computer can see it but the point is is that there are mark we all are leaking our psychological state all the time through our use of word are Are there technologies out there, you know, that are commercially available that would allow us to do an analysis of everything we've written on email, Slack, social, et cetera, to tell us if there's any warning signs that we should be paying attention to?

1:10:56I have my own computer program and there's a commercial version of it, but my computer program is called Linguistic Inquiry and Word Count, L-I-W-C. We pronounce it Luke. It doesn't look like Luke, but hey, it's mine. I call it Luke. And so you could, if you just do a Google search, you can find where it is and you can enter text and it can analyze it or you can buy the program. And so there are ways that such programs do exist. I'm just wondering what the profile would be looking at the text of someone who doesn't use I or you and just answers in one word like yes, no, ooh, okay They're deeply disturbed I can't I'm struggling to guess who she could be referencing Jamie I mean, I'd be very concerned about them.

1:12:05Bianca, before we go, any more questions on your side? Not that I can really articulate. I'm just grateful to know more about it, truly. I was a psychology major in college, and I have to say, social psychology was tough for me because it was really difficult to sort of define, categorize, measure things. And this, in many ways, just feels more complete and relatable, at least as a clinical person. So thank you. That's exactly what I wanted to hear. Thank you. Jamie, before we let you go, two questions I ask at the end of every interview. One is, the first is, is there something you were hoping to talk about that we didn't get to?

1:12:58No, I can talk about lots of things. And I think what we did was just fine. Okay. And then the final question is, can you please just list some books you've written and other resources you've put out into the world that you would like listeners to know about? For the language work, I have a book called The Secret Life of Pronouns. It came out about 10 years ago. I've also written and co-written a few books on expressive writing and opening it up by writing it down, words, books like that. So you can just Google my name and go fishing. I also have a website through the University of Texas and there's lots of publications there if you're interested in a racial word.

1:13:44Okay, we'll put links to the website and the books in the show notes so that people, if they want to learn more, can get it. Having said that, this was a delight. You're really fun to talk to. Bianca, as always, you did a great job as well. So thank you both. Thank you. I thoroughly enjoyed this. Thank you, guys. Thank you so much to everybody who worked so hard to make this show. 10 % Happier is produced by Tara Anderson and Eleanor Vasili. Our recording and engineering is handled by the great folks over at Pod People. Lauren Smith is our managing producer. Marissa Schneiderman is our senior producer.

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