Writing Your Way Through Feelings: Therapeutic Writing for Emotion Regulation

Abstract

Difficulties in emotion regulation underlie many psychiatric disorders, are associated with poor socio-occupational functioning and poor outcomes in treatment; hence from a core focus in psychotherapy. Although writing tasks are part of many psychotherapy interventions, evidence is sparse regarding the effects of writing on emotion regulation. This case report presents the use of therapeutic writing for emotion regulation, as an adjunct to psychotherapy. The client had a long history of emotionally unstable personality disorder, and persisting clinical risk and socio-occupational dysfunction despite several previous stints of psychotherapy. In addition to thrice-weekly in-person sessions, structured daily writing tasks were designed for her, with suitable probes and questions postulated to help with specific aspects of emotion regulation. Following four weeks of intervention (30 writing sessions and 17 in-person sessions), improvements in emotion regulation were noted [Difficulties in Emotion Regulation Scale scores 128 (pre) and 93 (post); reappraisal sub scale of Emotion Regulation Questionnaire 11 (pre) and 23 (post)]. The benefits and putative processes involved in such a writing intervention as experienced by this client are discussed. Despite limitations to generalizability from case report findings, therapeutic writing shows promise as an adjunct to psychotherapy in addressing emotion regulation. Therapeutic writing may have potential advantages in providing a way to internalize the skills, enhancing clients’ agency and clinical outcomes, reducing burden on healthcare systems; and bears further research as a stand-alone intervention.