There are many lifestyle changes that can help you sustain recovery from a substance use disorder. These include treating mental health issues, spending time with supportive people, eating healthy, exercising regularly, and getting enough sleep. There are also supporting practices that can help you stay positive, stay focused on recovery, and understand yourself better. These are often referred to as spiritual practices, and may include meditation and prayer–and, perhaps, writing. Here’s why writing can be a powerful recovery tool and how to make it part of your recovery plan.
Good mental health should be a primary concern for anyone recovering from addiction. According to the National Institute on Drug Abuse, more than half of people with substance use disorders also have co-occurring mental health issues and some experts believe that percentage is even higher.
Major depression and anxiety disorders make up the most common mental health challenges in America and they significantly increase your risk of developing a substance use disorder. For example, one study found that among people with a mood disorder, such as major depression or bipolar disorder, there was about a 30 percent chance of developing a substance use issue at some point–more than three times the rate of the general public.
Other conditions, such as PTSD, schizophrenia, and borderline personality disorder are less prevalent but they increase your risk even more. If you have one of these conditions, there’s at least a 50 percent risk you will develop substance use issues. Trauma is especially common among people with substance use disorders. Therefore, treating co-occurring substance use issues and maintaining good mental health is essential to a long recovery from addiction.
Research over the past 30 years or so has found compelling evidence that writing improves your mental health. This area of research was pioneered by psychologist James Pennebaker in the 1980s and has since been expanded by other researchers. Expressive writing has been linked to more feelings of wellbeing, better mood, and fewer symptoms of depression and anxiety. Although writing can benefit anyone, it appears to especially benefit people who experience anxiety and depression, and people who have experienced trauma, especially if they have difficulty expressing themselves.
Writing can improve your mental health on its own and it is also a useful tool for therapy. People very often have difficulty expressing themselves verbally, especially when they are feeling emotional or trying to confront something they’re ashamed of. Often, it’s much easier to write about it. Writing is more private and you feel like you have more control over it. You can’t unsay something but you can unwrite something if no one has seen it. Writing also uses different parts of your brain than speaking and you might find this gives you slightly different access to your thoughts and emotions. This is also why other forms of expression such as art and music are often helpful in therapy.
In Pennebaker’s original study, and many studies to follow, participants were divided into four groups. Three of the groups were asked to write about traumatic life events for 15 minutes on four consecutive nights. The fourth group was asked to write about trivial topics for the same amount of time. All participants were then tracked over the next six months. It turned out the participants in the expressive writing group made fewer trips to the student health center.
Pennebaker was originally motivated by the idea that keeping secrets makes us physically sick. He admits that the evidence for this theory has never emerged but research by others in the time since his early experiments has shown that there is, in fact, a connection between expressive writing and better health. Various studies have liked therapeutic writing to lower resting blood pressure, less severe symptoms of irritable bowel syndrome, improved walking and less pain in people with rheumatoid arthritis, and improved symptoms and fewer trips to the doctor for people with colorectal, breast, or prostate cancers. All of this is in addition to improvement of depression and anxiety symptoms.
We don’t know exactly why writing improves physical health. It likely has something to do with reducing stress and anxiety. We know, for example, that stress hormones like cortisol cause damage to the body and the immune system when they remain high for long periods. A reduction in anxiety and rumination likely reduces stress and its associated hormones as well. However, it’s possible that there are several mechanisms at work.
Different methods of writing have different effects. Before we get into those methods there are a few caveats to keep in mind. First, if an intervention is powerful enough to help you, then it can also harm you. This is true of writing as well as medication. If you use your writing as a way to focus on every awful thing in your life, you are likely to end up feeling anxious and depressed. Even when used as directed, expressive writing has been known to make people feel worse. If that happens to you, stop writing and maybe consider taking a different approach or trying again later.
Also, writing is not a replacement for therapy. It is best used as a therapeutic tool or as part of a recovery plan to help maintain good mental health. If you struggle with a mental health issue such as depression, an anxiety disorder, bipolar disorder, a personality disorder, or other issues, seek professional help and use writing to aid in the process. That said, here are some specific approaches to writing that you can incorporate into your recovery plan.
Most of the research cited above uses a particular protocol based on Pennebakers’ original study. First, pick a stressful or traumatic event that has happened to you. It doesn’t have to be the worst thing that has ever happened to you, just something that is painful, embarrassing, or uncomfortable to think about. It also shouldn’t be something that has happened recently, so go back at least a few months. This is also a good filter, since we tend to remember emotionally challenging events for longer.
Next, set a timer for 20 minutes. You want to write about this event continuously for the entire time. Setting a timer and writing continuously helps silence your inner editor so you can dig down to your true feelings. Don’t worry about punctuation, spelling, or grammar. Also, don’t worry about anyone else reading what you write. This exercise is only for you. Make sure as you write that you’re focusing on the actual events and your feelings about them.
Repeat this exercise for four consecutive days. If you start to feel overwhelmed while writing or you feel like you’re going to break down, stop writing. It’s normal to feel a bit sad or angry during and after the exercise but it shouldn’t feel overwhelming. People doing this exercise typically start to feel better in an hour or two. You should also feel less emotional on the third or fourth day than you do on the first day.
There is quite a bit of evidence that this practice produces tangible results but we don’t know exactly why. Part of it is likely that you can re-experience and process a traumatic event in a safe environment. We often get into trouble when we try not to think about a traumatic event and allowing ourselves to experience it takes away its power. Through writing about it repeatedly, you also become desensitized to it because you start to feel like, “This again?” People seem to respond especially well to this exercise when they are able to discover some kind of meaning in their traumatic event, such as discovering they can survive adversity or discovering a deep connection with others who have been through the same thing.
There is also an abbreviated version of this practice that research suggests can minimize anxiety about an upcoming event. If you’re worried about something you have to do–take a test, go to an interview, give a presentation, go on a date, etc.–take about five minutes sometime before and write down all your feelings about the event. Don’t think, just write. When you’re done, crumple the paper and throw it out.
There are two primary ways you can use writing to enhance formal therapy. One is to do your homework. Therapists often give you assignments during the week. There is usually a good reason for these assignments and skipping them is a bit like taking piano lessons but not practicing during the week.
One common assignment for therapists who practice cognitive behavioral therapy, or CBT, the most common form of psychotherapy, is the ABC exercise, which stands for activating event, belief, consequence. In this exercise, you identify some challenging emotion–the consequence–that you experienced during the day. Then you identify the activating event–what caused you to feel that way. Finally, you try to identify the belief that connects those two things.
For example, you might feel depressed as a consequence of missing an important deadline at work. The belief connecting those two might be that you think you’ll get fired and end up homeless–examples of the cognitive distortions of jumping to conclusions and catastrophizing, respectively. By doing this as a writing exercise for a week or two, you begin to understand how your thought patterns affect your emotions.
The other way to use writing to enhance therapy is to keep a therapy journal or just write about therapy in your regular journal. Write about what you discussed during the session, how you felt about it, any insights you gained, and anything you might have thought of after the session. Continue to relate the events of the week to topics you’ve covered during therapy. This way, therapy isn’t just a 50-minute chat, but rather something that you apply directly to your life.
Gratitude has been a popular topic of research in recent years because of its role in the positive psychology movement. Research has identified a number of benefits to practicing gratitude, including better relationships, more feelings of happiness, improved sleep, better health, fewer symptoms of depression, and even fewer thoughts of suicide. Pretty much anyone would enjoy these benefits and they are especially important for people recovering from substance use disorders. Cultivating gratitude is also a good antidote to negativity and resentment, which are like poison for sobriety.
Unfortunately, people who are considering treatment or who have just started recovery often feel that they don’t have much to be grateful for. Asking for help for addiction typically comes at a low point. The good news is that there are two writing practices, which, when done regularly, can cultivate feelings of gratitude.
The first practice is to keep a gratitude journal. This is very simple. Just write down three things each day that you’re grateful for. It could be something big, like a family member helping you get into treatment or it could be something small, like the weather was unseasonably pleasant. It doesn’t matter as long as it was something you were grateful for. It’s also better to focus on a few things and write about them in some detail rather than trying to make an exhaustive list. Do this every day for about a week or two, then pick one day a week–perhaps Sunday–and continue to do the practice weekly. One study found that when participants did this exercise once a week for 10 weeks, they felt more optimistic and generally better about their lives. They also made fewer trips to the doctor and more trips to the gym.
The other writing exercise that can significantly increase gratitude and happiness is writing a gratitude letter. Think about something that someone has done for you that you sincerely appreciate but you never really thanked the person for. Write a letter to that person describing what they did for you and why you appreciated it. You can deliver this letter if you want; doing so will probably make the other person feel good and it will likely strengthen your relationship. However, you can get the benefits even if you don’t deliver it. You always have the option of delivering it later.
Daily journaling has benefits beyond those noted above. It can be a way of relieving stress–getting things out of your head and onto paper so you don’t ruminate on them. It can also be a way to better understand yourself and your behavior. We are surprisingly bad at spotting our own patterns and having insight into our own motives. If you make a habit of writing about what happened, why you think it happened, and how you felt about it, you will start to notice patterns and gain insights. It can also be helpful for making big decisions. Describe the problem you’re dealing with and your considerations for solving it. Write down your whole thought process. Whether your decision turns out to be good or bad, you can learn something by having a record of the process.
Maybe you’re persuaded that writing can have real benefits for addiction recovery but you feel like it’s not really for you. Maybe you’re not comfortable expressing yourself in writing. That’s fine. You don’t have to be Tolstoy to get the benefits described above. Many people who had never even thought about expressing themselves in writing have discovered the power of putting pen to paper. Here are some tips to help you make regular writing a part of your recovery plan.
The first thing is to make writing part of your daily routine. You’ll be surprised how much easier it gets when you do it every day at the same time. It’s also important to tie it to something you already do every day. So, for example, you might decide to write first thing in the morning–which is also good for helping you remember and analyze your dreams–or you might decide to write after dinner. In the evening before you get ready for bed is a good time because it gives you a chance to reflect on the day, to consider what went well, to work through challenging emotions, and so on before you lie down to sleep. Whatever time you choose, the point is that you want to immediately go from one task to another. For example, you might finish dinner, then take out your notebook.
When you’re trying to make writing part of your routine, start small. Don’t try to write your whole life story. The very smallest thing to do is to open your notebook; even if you write nothing at all, just opening your notebook everyday at the same time helps establish the habit. Next, just write what happened that day–”I went to work, I went to my 12-step meeting, I had dinner with Mom, I took a walk.” If you’re doing a practice like gratitude journaling, just write your three things. It won’t be long before you start filing in details and commentary. Let it grow organically and don’t feel like there’s one right way to do it.
Finally, don’t make writing harder than it needs to be. What you write is for you alone. Don’t think about what your ninth grade English teacher would say. Don’t try to impress anyone. Don’t worry about getting a fancy leather-bound journal and a nice pen. If you have nice materials, you suddenly put pressure on yourself to write something good. The point is to get the whole mess on paper and sort it out later.
A daily writing practice can be a powerful addition to the other elements of your recovery plan. Writing is a way of digging deep into what’s going on in your life and recovery. It gets you beyond superficial observations and explanations. It’s also a record of your recovery journey and it can remind you of how far you’ve come. At Steps Recovery Centers, we understand that recovery from addiction is a holistic and individual process. Our programs are based on the time-tested 12-step principles. To learn more about our program options, explore our website or call us today at 385-236-0931.