Abstract
Letter writing has been shown to be an effective intervention for individuals when navigating complex emotions, such as grief, guilt, or loss or shame. In navigating a romantic relationship, letter writing can be an effective tool to express one’s feelings in a healthy and productive manner. It is important that the individual understands the outline of writing and sending a letter, in order to clearly articulate their thoughts to the individual that they are in a romantic relationship with. An underlying humanistic counseling approach lays the framework for considering the whole person with an emphasis on strengths. Through narrative therapy, one is able to rewrite their own story and conceptualize alternative endings. Applying letter writing to couples as well as rules, procedures, and an example of a letter is included to demonstrate the potential efficacy of this intervention. Covid implications and future research directions are provided.
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Introduction
The United States Postal Service (USPS) (2021) has seen a year-to-year reduction in mail volume since 2006, when it peaked at roughly 213 billion units. By 2021, this number had declined to around 128.9 billion units. Handwritten letters are rarely used these days, as convenience has taken precedent, with digital text media offering almost immediate delivery (Kim et al., 2019). Handwritten notes are more costly due to the stamps, stationary, and manual spell check (Coleman, 2013). Emails, tweets, texts, and Facebook messages are free and also simple to write and send. Due to the speed and convenience, digital text media is frequently utilized for communication. The art of letter writing has seemed to have lost its luster somewhere in between T9 word texting to emojis to direct messages on social media. Fragments, abbreviations, and bitmojis have replaced similes, metaphors, and punctuation. Is it that we simply do not value complete sentences or thoughts anymore? Who has the time to express our feelings to our partners when we can easily download a dating app and swipe to the next potential loves of our lives? Although the digital world is convenient, the art of physically writing a letter provides benefits that texting simply cannot.
The utilization of letter writing has been thoroughly researched as a therapeutic intervention by various scholars (Andrews et al., 1997; Constantin, 2019; Epston, 2009; Hartman, 1990; Prasko et al., 2009; Voskanova, 2015). Voskanova (2015) posited that it was easier for individuals to write rather than to speak, particularly through processing shame-based emotions. Voskanova (2015) used letter writing as a means to express shame-based emotions and found that letter writing allows for the opportunity to express their feelings through writing. Finally, letter writing encourages setting safe boundaries more than in typical “talk” therapy because the client has control over who can read what they wrote (Voskanova, 2015). In another study, therapeutic letter writing was showcased in a multitude of different therapeutic modalities such as narrative therapy, cognitive behavioral therapy, and psychoanalytic approaches (Prasko et al., 2009). Therapeutic letters offer clients an unequivocal release from negative feelings and processes that talk therapy was not shown to provide (Prasko et al., 2009). This paper’s outline entails a review of the literature on letter writing, the intersection of letter writing and narrative therapy, guidelines and process of letter writing as an intervention, a letter example, COVID-19 considerations, and future directions.
The purpose of this paper is to demonstrate an innovative way to letter write as a systemic, therapeutic intervention. This paper expands on existing approaches in narrative therapy by providing specific guidelines and detailed considerations when engaging in letter writing. Further, the term “Dear John” in the title was an analogy, moreso parody, of the 2010 movie based on the 2006 novel by Nicholas Sparks. We drew the connection due to the letters written between partners in that movie. The following section will outline the existing literature on letter writing as a therapeutic technique.
Review of the Literature
The therapeutic effect of writing about personal experiences is supported by evidence-based practices for individuals, couples, families (Voskanova, 2015). The therapeutic process of letter writing can be used with different groups, as well as in different institutional settings such as group therapy, group treatment programs, partial hospitalization programs (PHPs), and intensive outpatient programs (IOPs). There are different types of letters associated with letter writing, and each type of letter has a distinct meaning and purpose for why and how it is written. For example, in family therapy, there are letters that may be useful when working with families in which an adolescent struggles with non-suicidal self-injury (NSSI): collaborative letters, letters to one’s self from the present, letters from the future, and parallel letters (Hoffman et al., 2010). Further, there are numerous counseling models and therapeutic tools that use structured journaling and writing in counseling sessions (Butler, 2016; Hoffman, 2008).
Letter writing is a layered and nuanced intervention because often there are emotions that may nessecitate breaking down and processing what is being written on paper. Letter writing allows the author an opportunity to articulate their thoughts through creativity, analogies, puns, alliteration, and whatever else feels fitting. For example, therapeutic letter writing can provide insight into their thoughts, feelings, and current emotions and word it as they see fit (Constantin, 2019). Therapeutic letter writing serves as a means to work through trauma in a creative lens (Constantin, 2019). Letter writing can remind to the individual of the strength and reflection on their life experiences; moreover, it is used as a tool to inspire conversations and provide context about needs, fears, and desires (Signs, 2015). Furthermore, letter writing gives the opportunity for reflection, an increase in accountability, and to accept responsibility as needed throughout the process (Christenson & Miller, 2016).
This intervention can often conjure emotions for individuals as there are many emotions that coincide with the process of letter writing such as guilt, shame, loss, and grief (Keenan et al., 2014; Voskanova, 2015). With letter writing, individuals are able to address their emotions related to the trauma and even address the person or people involved in it (Keenan et al., 2014). Letter writing provides a safe way for individuals to express difficult emotions they normally may not share (Davidson & Birmingham, 2001).
Letter writing can be a beneficial aid in healing within different populations. The benefits of letter writing provide healing and safety for the author of the letter (Voskanova, 2015). Writing instead of voicing something can foster a sense of safety and protection for the individual as a way to process shame, guilt, trauma, and loss (Voskanova, 2015). This healing process emphasizes the importance of telling one’s story in order to heal and express their trauma (Keenan et al., 2014). Letter writing is especially seen as beneficial and relieving for veterans because narration helps to accept and process one’s traumatic experiences and move forward with their life (Keenan et al., 2014). Letter writing is a suggested therapeutic process similar to journaling because there is no assigned timeframe, length, or format, only to be expressive in however way the author sees fit (Voskanova, 2015). Other populations that therapeutic letter writing can be beneficial for are those with psychotic disorders, anxiety disorders, and experience problems with memory and attention and those who do not understand deep-seeded emotions (Prasko et al., 2009). The reason these specific populations have success with therapeutic letter writing is evidenced by when writing therapeutic letters, individuals are encouraged to work through deep emotional schemas—such as helping the client understand, identify, and eventually process difficult feelings in order to free themselves and regain control over their narrative (Prasko et al., 2009; Voskanova, 2015). Due to the flexibility and broad efficacy for multiple populations, letter writing has shown to be an extremely valuable tool to utilize when processing emotions.
Beyond the therapeutic setting, there are other areas where letter writing can be helpful. Longer-term physical health outcomes, such as medical visits due to illness, lung, liver function, blood pressure, and number of days within the hospital, are significantly improved by expressive writing (Baikie & Wilhelm, 2005). Additionally, writing on emotional issues altered how individuals interacted with others, implying that writing can influence objectively measured social and linguistic behavior (Baikie & Wilhelm, 2005).
Outside of an individual, letter writing can also work within groups and create group cohesion. The concept of “communalization” is demonstrated in group therapy when integrating letter writing as a therapeutic intervention; this occurs when an individual feels safe enough to share their story with another who can be trusted to listen and retell their story (Keenan et al., 2014). Letter writing helps individuals build upon relationships within their group, normalize their experiences, receive social support, and learn from others (Keenan et al., 2014). It aids in giving any amount of authority and power back to the author they feel they may have lost to the trauma they endured, and these letters provide an opportunity for reflection by the author before communication with any other party (i.e., family members, partner, etc.) (Davidson & Birmingham, 2001; Signs, 2015). In regards to couple or family therapy, some therapists choose to ask certain family members to leave the session due to the nature or content of the letter; the content of the letter can trigger or become emotionally harmful for the client (Voskanova, 2015). Not all therapists share the same perspective on asking family members to leave the session during family therapy for an individual to read or write their letter, especially when asking someone to leave can be difficult (Voskanova, 2015). A number of family therapists use therapeutic letter writing to engage absent family members and to focus and acknowledge the contribution of certain family members in different ways on the client (Vidgen & Williams, 2001; Voskanova, 2015). Similarly, keeping family members in session as clients read or write their letters shows how the use of therapeutic letter writing co-occurs around healing and growth (Vidgen & Williams, 2001). There is no standard for therapeutic letter writing, including what therapists may choose what to do or not to do during a session regarding keeping family members in the room (Vidgen & Williams, 2001). The following section will outline the theoretical framework for letter writing, through a narrative therapy lens.
Theoretical Underpinnings: Narrative Therapy
Narrative family therapy is a form of psychotherapy that helps individuals deal with various problematic situations in their life through helping them identify different values and skills that they may have (Combs & Freedman, 2012). This framework is utilized to listen to clients’ personal experiences and assist them in developing techniques for reauthoring stories that lead to self-empowerment (White & Epston, 1990). Narrative therapy has been found to be effective in treating blended families, infidelity-affected couples, addressing adoption issues, families with adolescents who identifying as LGBTQ+, reducing parent–child conflicts, supporting homeless families, and improving the family functioning (Suddeath et al., 2017).
Letter writing is an innately narrative technique (AnjaBjorøy & Nylund, 2016; Hoffman & Kress, 2008; White & Epston, 1990). Letter writing can be used as a physical approach to externalize, name, and confront a problem in the context of narrative therapy. As a result, letter writing allows a client to trace their story through time at their own speed, while also identifying potential future courses and opportunities for change (Hoffman & Kress, 2008). The narrative metaphor states that a person experiences different events in their life through different stories. Therapists who practice this form of therapy look to help enrich the client’s life (Combs & Freedman, 2012).
The foundation of letter writing is ingrained in narrative therapy because it is believed that people “write their own stories” (Davidson & Birmingham, 2001), which individuals are doing when they participate in letter writing. The use of letter writing as a form of a therapeutic practice is most commonly associated with narrative therapy (Hoffman, 2008; Keenan et al., 2014; Signs, 2015). This is because, similar to journaling, letter writing is targeted through narrative therapy as a form of story-telling (Keenan et al., 2014). Letter writing is an integral part of narrative therapy (Hoffman, 2008; Signs, 2015) and is used as a therapeutic tool within numerous counseling sessions because of the freedom, comfort, and relief it provides clients in “letting go” of whatever it is they are holding on to. This is because, for many, writing is easier than speaking (Voskanova, 2015).
Narrative family therapists must also be aware of the language that clients utilize in their stories, as well as the impact that language has on comprehending and identifying their experiences (Suddeath et al., 2017; Tadros et al., 2022a). Tadros et al. (2018) utilized narrative therapy in a case study to help a client cope with her anxiety and panic. Using narrative therapy techniques, she was able to reduce her anxious symptomatology as well as create agency to help her retain her good academic status. Further, narrative therapy has also been shown to reduce post-traumatic stress disorder (PTSD) and aggression in individuals who were soldiers in Congo (Koebach et al., 2021). This therapy helped relieve PTSD symptoms and reduced aggression, but also showed a decrease in substance use and other psychosocial problems such as depression (Koebach et al., 2021). Although the study consisted only of males aged 18–75, the study showed great results that narrative therapy can be used to help individuals of varying backgrounds that contain different problem areas, race/ethnicity, education, and socio-economic status. It is critical for a therapist to approach each client as an individual with a problem, rather than the problem, and to be able to restore the client’s authority. By recognizing positive strengths and resiliency traits, therapists can help their clients feel more empowered (Tadros et al., 2018, 2019). Thus, narrative encompasses resilience and empowerment which can amplify voices that have typically been silenced. This can be specifically applied to couples, which is highlighted in the next section.
Application to Couples
Letter writing is considered a successful narrative therapeutic technique and intervention for couples, families, and individuals (Signs, 2015; Voskanova, 2015). The literature above has documented the variety of positive effects of letter writing (Keenan et al., 2014; Signs, 2015; Voskanova, 2015). We argue that letter writing can be an intervention utilized systemically. Letter writing can be used individually, but tends to be more successful looking through a systemic lens, such as with couples and families. Writing a letter to your partner may be beneficial, as expressing oneself may be easier through writing rather than speaking directly to one’s partner (Hoffman et al., 2010; Voskanova, 2015). Letter writing can make it easier for partners to communicate what they are feeling without fear of judgment, ridicule, or stigma.
Letter writing is individually centered, which means it is transformative for each individual client based on their experience—such as through writing words of self-encouragement and self-support, to a significant other, a loved one, a family member, or potentially someone who is deceased (Voskanova, 2015). If and when an individual shares their letter is an opportunity for family members to be there for the individual when shame is experienced, interact with those emotions, and work on it during the session (Voskanova, 2015). Any content revealed in family, couples, or group therapy can be triggering, emotional, and/ or traumatic. Letter writing allows for processing without the threat of stigma (Davidson & Birmingham, 2001). Letter writing provides an advantage for individuals who express themselves better in writing than in speaking (Hoffman et al., 2010). Letter writing provides an outlet for individuals to express their emotions, feel less alone in their struggles, and feel a greater sense of empowerment (Butler, 2016; Hoffman et al., 2010).
Writing about one’s relationship is a low-cost method to build a symbolic representation of the partnership’s experiences, emotions, and shared meaning that exists within the relationship. Allgood et al. (2019) explain that positive relationships between marital satisfaction and both first-person plural pronouns (i.e., we, ours) and positively affect language usage during an emotional writing (EW) exercise. Those who use more plural personal pronouns may be more likely to consider themselves as part of a collective entity (Allgood et al., 2019). Further, expressive writing interventions (EWI) have been shown to help couples and women with infertility. Frederiksen et al. (2017) allowed infertile couples to express and explore their often-suppressed feelings and thoughts about infertility. The writing sessions were meaningful to both partners and women in the EWI group, and they were more likely than controls to expect them to improve their physical and emotional health (Frederiksen et al., 2017).
L’Abate (2008) suggests distanced writing (DT) for distressed couples as an alternative or supplement to traditional face-to-face or talk-based therapy. Any therapeutically relevant writing homework assignment completed by participant couples outside the physical presence of a therapist, who is nonetheless accountable for the therapy’s direction, is referred to as distanced writing (L’Abate, 2008). DT is the most common method for homework assignments in several schools of psychotherapy and for a variety of clinical conditions. Tasks, written instructions, handouts, worksheets, and reproducible materials are all included in these assignments (L’Abate, 2008). Regardless of the circumstances, couples should meet at a definite date, time, and location and choose a date and time when they can meet as regularly as possible to discuss, compare, and contrast their responses to completed assignments.
Furthermore, sexual expression has an essential role throughout every human developmental stage and is incredibly important in the later life stage, when interactions with loved ones are vital (Cornwell & Waite, 2009). Unfortunately, in older adults, the need for sexual expression is frequently disregarded, if not deliberately suppressed (Tetley et al., 2016). Internalized societal norms and meanings of sexuality, according to the sexual scripts theory, determine human sexual behavior, sexual responses, and emotions regarding sex (Muruthi et al., 2018). Similarly, narrative therapy holds that meaning is co-constructed and that change occurs through the creation of new meaning. Specific strategies and techniques can be used by older adult couples to maintain intimacy and reasonable expectations as they age. Therapists elicit client sex narratives and listen not just to the client’s bodily responses, but also to their past, present, and future thoughts, feelings, and meanings (Muruthi et al., 2018). The therapist's goal is to find different interpretations within the stories of when the couple’s sexual demands were met in their relationship. This new alternative narrative allows clients to examine their own history and sequence of events, as well as how these alternative meanings formed new stories that may contradict the cultural scenarios’ expectations (Muruthi et al., 2018). The following section will outline the letter writing intervention.
Letter Writing Intervention
When wanting to express something to a romantic partner, letters are not often thought of as the means to do so. Popular culture perceives vulnerability as “weak,” and rather than wear one’s heart on their sleeve, they should keep those expressions to themselves. For a female, expressing such thoughts might seem as “overdramatic,” and for a male, writing a letter might be seen as “weird” or “trying too hard.” The cliches heard time and time again such as “Catch flights not feelings,” “On to the next,” and “Thank you, next” all reinforce this notion of keeping emotions and feelings hidden rather than expressing them.
However, letters are a powerful and extremely beneficial tool to express emotions in any capacity towards another person in a healthy manner (Pennebaker, 2004). When one sits with their thoughts and has time to process them, they are able to articulate in a more cohesive manner rather than if they were speaking at the moment and reacting to a situation. There is no pressure of having to gauge the other person while expressing how you feel towards them. There is no one to interrupt your thought process, so you are less likely to forget something you wanted to say or realize in hindsight you wanted to mention something that you forgot. Sharing with others in person is scary, as you are obtaining feedback from them in real time, which means that the other person can directly reject you. Even worse, for some, the individual can stonewall you and give vague, indirect answers that do not answer or address what you wish to talk about. This can be incredibly frustrating.
We are in a time when paper is phasing out of style, making it difficult to appeal to the younger generations the benefits of letter writing. Who wants to purchase stamps, an envelope, and locate their nearest UPS, FedEx, or USPS? Although physically handwriting a letter would be the ideal design of this intervention, letter writing from a technological perspective means that the Notes app on phones is a substitute, as is a Word document or a Google document. Utilizing technology allows for edits and revisions to be made, even by others as well. Rather than writing a letter and immediately sending it, the revision aspect is crucial so that others are able to provide feedback. Letter writing provides a pause that sending an immediate text or speaking in person does not. Letter writing as a therapeutic intervention has been readily encouraged for individuals to break the silence through letters, often by giving back the author power, authority, and respect they may feel they did not have prior (Davidson & Birmingham, 2001). Letter writing as a therapeutic intervention encourages the person to “find their voice” as it relates to creating their letter and, if shared with who the author is writing to or about, may elicit care and support from that person (Davidson & Birmingham, 2001).
Before beginning to write the letter, there are helpful questions to reflect on in order to shift one’s headspace, as well as explore the overall purpose of writing the letter. These questions are not exhaustive; however, it would be beneficial to think about before writing the letter.
Questions to Consider Before Beginning
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How do I feel when beginning this?
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What should I do to get in the right headspace to write this letter?
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How do I feel about giving up control?
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How do I structure this so all my points are addressed?
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What is my goal in writing this?
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How do I want to feel after finishing?
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What is my plan if I feel worse after?
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Do I share with my friends that I’m writing the letter? If so, do I let them read it?
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What if my friends do not agree with what I wrote?
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How vulnerable is too vulnerable?
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How long should this letter be?
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Will it be too long that they get bored or not bother reading it?
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Would I be okay with my partner reading this? If yes why? If no, would you want to rephrase, omit something, add more, tone?
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How will my partner react?
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Will my message offend them?
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Will this break us up?
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Will this message be received how I intend it to?
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What is my plan if this person does not respond?
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What if I don’t get the response I want?
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What is the best outcome if they read this? Worst outcome?
Rules
There are important rules of letter writing to keep in mind. It is important to note that letter writing is not recommended within a relationship where intimate partner violence or abuse is present, as this can escalate tensions and pose the risk of increasing the intensity of violence (Adams, 1988). The first rule to keep in mind is that there is no deadline or even a guarantee that the individual will respond. Creating a deadline in your mind will only result in feeling let down when this time comes and goes with no response. Rather, it is important to remember your purpose for writing the letter and how it feels for you, as compared to being focused on how that other person will receive it. Externalizing is an important concept to separate people and problems (Combs & Freedman, 2012). There is no page requirement; however, it is important to make sure that what you are saying is concise and easy to understand. It is also crucial to utilize language in a colloquial way, similar to how you would speak. There is no need to utilize proper grammar or speak in academic terms when writing this letter. Additionally, it can be beneficial to reference inside jokes or stories, as this provides a bond or connection, even if others may not necessarily understand your references.
No Blaming Statements
Blame can be expressed in a variety of ways, including open accusations or complaints, as well as more implicit expressions of demands and desires (Päivinen et al., 2016). Blame is a powerful attribution that elicits shame, guilt, anger, and defensiveness, which obstructs connection and makes problem-solving more challenging (Friedlander et al., 2000; Päivinen et al., 2016). When couples are in conflict, “I” statements are exchanged. Couples may not know how to empathize with one another’s situation. Instead of blaming each other, they could learn to paraphrase each other’s responses, reflect on their feelings, own their feelings, and take responsibility for their distress (Sinclair & Monk, 2004). When conflict is seen as arising from individual or couple deficits, it invites a universal, totalizing, essentialist view of the situation. The result is frequently a blaming exchange in which partners are set against each other’s “truth-based” assumptions (Sinclair & Monk, 2004). Utilizing “I” statements is beneficial to explain one’s own feelings without blaming the other individual (Rogers et al., 2018).
Fair Rules of Fighting
Conflict is inevitable. Learning how to handle conflict with a partner is an important aspect of maintaining a healthy relationship. The following is a list of suggested fair-fighting guidelines to assist couples in resolving conflict without harming the relationship: first, no degrading language (Cobb, 2013). Avoid name-calling, insults, put-downs, or swearing. Putting your partner down or criticizing their character shows disrespect towards their dignity. The second is no blaming (Cobb, 2013). Blaming a spouse diverts the attention away from the problem at hand. It pushes one’s spouse to get defensive, escalating the conflict. Next is no yelling and no use of force. Yelling is a personal experience. What one may consider yelling may not be the same definition to you. Further, using or threatening to use physical force in any way is unacceptable. Subsequently, no talk of divorce, staying in the present, taking turns talking, and defining yourself and not your spouse are fair-fighting guidelines to help resolve conflict within the relationship (Cobb, 2013).
Fair fighting is an important notion for resolving conflicts and assisting couples in better understanding one another. When done well, the process of fighting frequently reveals more than the content of the argument. Fair fighting may strengthen the partnership if done properly and healthy. For instance, in late adolescence, interparental reasoning predicted reduced levels of autonomy undermining conduct between adolescents and romantic partners. This is consistent with the idea that adolescents can learn from their parents’ interactions by observing how they deal with conflict with their own romantic partners (Miga et al., 2012). Further, in early adulthood, interparental reasoning during conflict was also linked to higher levels of romantic relationship satisfaction and affection. This research adds to recent findings that paternal marital satisfaction predicts adolescent satisfaction in romantic relationships in late adolescence (Hare et al., 2009). Providing a model of conflict negotiation to couples and families will provide a foundation for implementing adaptive strategies.
Process and Procedures
As discussed, to date, there are various articles that show evidence for letter writing, but there are no guidelines on the process of writing the letter, such as what to include or what to not include. It is extremely important that individuals who want to write a letter to someone to process emotions have a guide or an idea as to what to consider, which does not exist in the literature. Once an individual has decided to write a letter, the first step should be drafting an outline to make sure that everything you want to share is accounted for. This can be very informal and more of a “brain dump” that consists of statements, phrases, or sentences related to what you want the letter to say. The next step in letter writing is putting all of your thoughts onto paper (or digitally). This part does not have to be grammatically correct and spelling does not count during this step; it is solely to get all of your thoughts out. In expressing your thoughts, it is important to utilize language that does not assign blame, but focuses on providing information. Communicating direct needs that you wish to have met and making sure that those expectations are realistic are crucial components of this step.
Once the letter is drafted out, feedback is the next step in the process. It is important that you obtain feedback from individuals who know both you as a person and the situation related to the letter, as well as your desired outcome. This can be in the form of friends, family, or other individuals who you feel will be honest in their feedback. After receiving this feedback, editing plays an essential role. This letter should experience multiple rounds of revisions and edits. The end of the letter should directly state what you wish to obtain or have changed from sending this letter and your ideal outcome.
Assumptions
In writing a letter, it is important to keep in mind the assumptions you may have. One assumption is that you assume the wants of another person, such as they want a specific thing and therefore you write operating under the assumption that is still what they want. Another assumption that you may have is that just because you want something or feel a certain way, that the other individual will also feel the same way because you are engaging in a change of behavior, under the assumption, it will change how they feel. It is important to not let the other individuals’ assumptions alter what you choose to write or not, as this letter is about you, not the other entity.
Power
Narrative family therapy allows for the understanding of modern power. This is a method used when a therapist realizes that their client has somewhat of a problematic story. Modern power comes from the understanding that there are typically central powers that govern us as people (Combs & Freedman, 2012). These central powers are typically figures such as kings, government officials, and other people in power assigned to governing society. Modern power switches the focus of having a central power and focuses on having each individual govern themselves (Combs & Freedman, 2012). Modern power further gives the individual the opportunity to create an inner source of power even though there may exist a lack of internal power. People typically attempt to create their identity through the typical societal norms (Combs & Freedman, 2012). Modern power allows them to be their own author when it comes to how they see themselves. It can be a powerful experience to put forth feelings into a letter. Particularly, letter writing may create an unbalance of power within romantic relationships. Unbalancing is a common structural family therapy technique, and this may be utilized in conjunction with narrative and letter writing (Minuchin & Fishman, 1981; Tadros, 2021).
Power is a dynamic that is present when writing a letter, but especially when sending the letter. Narrative therapists and mental health professionals alike find letter writing empowering in a way that allows the author to regain power (Butler, 2016) and to express feelings of compassion, gratitude, and forgiveness either towards themselves, their experience, and/or who the letter may be directed to (Christenson & Miller, 2016). The individual who receives the letter has the power, because they can respond to the vulnerability that the sender displayed, not necessarily share their own. The recipient has all of the information, and the sender has no insight into how the receiver feels until they share or answer. The sender therefore gives up all control when the letter leaves their hands, which can be frightening. In giving up power, it is crucial that individuals have the ability to self-regulate, as the feelings that accompany giving up power can be intense.
The following example was from a woman writing, to what the millennials and generation Z call, her situationship. This term is defined as not a formal exclusive romantic relationship; however, it is also not a friendship. The man she was in this situationship with, for parody purposes, we will call him John. Letter example:
Dear John,
I say out loud that I’m mad at you, but never to you. I’m not mad, I’m hurt. (In)Conveniently, we were both leaving. The months of silence I regret. My ego got in the way. I am not someone who cares about ego. My ego is bruised, I have never experienced this type of outright rejection before. Self-worth was not the issue- I have a plethora of good qualities. Still, you found a reason (or maybe plenty) to reject me.
I had to be the perfect daughter, sister, friend, girlfriend, etc. It seems that no matter how much I have to give, they take, and then leave me with little to no answers. What I do know is, I did not deserve what they did to me. It doesn’t make it easier knowing you could be “perfect” and still not enough. The only way to “obtain” love was to achieve, to deliver. I always did. I’m a chronic people pleaser. My whole life I chased the affection of those who were supposed to care for me. The unhealthy. The emotionally unavailable. I gave up who I thought was the love of my life and best friend. I questioned (judged) myself for not leaving. My love and loyalty know no bounds. He knew that, he took advantage of that, don’t they all? Does telling you this even bode well for me? I wanted to tell you about this one day. I couldn’t be vulnerable with you. I blame myself, but regardless, timing and distance was not in our favor.
I wanted you to know me. With every time I reached out, I felt more and more alone in this. What was this anyway? I had this need to give you whatever it is that you wanted. The overarching need was to protect you, I still don’t know from what.
To unpack the example above, we want to start by stating this is a fictional letter written for the purpose of showcasing a strong, healthy expression of emotions. The writer is expressing her feelings while bringing in the context of her past abusive parental and romantic relationships. Sharing her past in conjunction with her present feelings about the current situation may assist in bringing understanding and clarity. We recommend reading the above questions to ponder, rules and procedures before writing and sending. The considerations taken to write this letter are derived from the sections above: rules and procedures.
Cultural Humility and Social Justice
As with any aspect of research, culturally appropriate interventions are often excluded or not incorporated into practice (Tadros & Owens, 2021). This is not the case with this paper, as therapeutic letter writing should serve as a release for all individuals regardless of background, but needless to say, it is critical to integrate aspects of multiculturalism to better understand and help diverse populations. Therapeutic letter writing can be seen as self-help technique (Jolly, 2011), despite its roots in various different theoretical orientations. At times, “self-help” is not an option among collectivistic cultures where putting the needs of the individual first is frowned upon. A collectivistic culture is where family is at the center and family members closely identify with one another and help make decisions for the family as a whole instead of individually (Brady, 2021). Often in these cultures, loyalty, sacrifice, honor, and family are centered and prioritized (Brady, 2021). It is a privilege to be able to partake in therapeutic letter writing without having to worry about the extent of misrepresenting family members, community, and the risk of “ruining” the family name. This is because therapeutic letter writing is both individual and familial (Jolly, 2011), which is a significant factor to keep in mind when working with individuals who come from collectivistic culture. Family is often at the center of collectivistic cultures and boundaries tend to become blurred, so realizing that therapeutic letter writing may have limits and bounds for individuals who come from these backgrounds (Brady, 2021).
Limitations
There are numerous limitations to utilizing letter writing as an intervention. When being emotionally vulnerable, there is a lot that can arise both when writing the letter as well as sending it. A qualitative study discussed letter writing as an alternative to counseling and/or medication for depression and anxiety (Wright, 2009). It is normal to feel anxious, nervous, and to even hyper fixate on the situation as well as the person that you are writing to. Especially once the letter is out of your control and either in the physical or digital mail, these feelings may intensify. One’s own level of comfort with sharing may also limit the potential benefit of this intervention (Kleiven et al., 2020). This may be too overwhelming for individuals who are not prepared to have such feelings. Additionally, writing does not take into account tone of voice or nonverbal expressions that can further explain one’s feelings or thoughts towards a situation. By relying on only written words, some key messaging may be missed.
COVID Application
During the time of the COVID-19 pandemic, individuals are experiencing, maybe for the first time or in a more intense manner, the feeling of isolation. Letters are a thoughtful gesture that may improve connection during a time of isolation as a result of the COVID-19 pandemic. If a loved one contracted the disease, then more isolation was required. Due to the rapid spread of the virus, the infected loved one and those who love them are unable to be physically near each other (Tadros et al., 2022b). Further, during the COVID-19 pandemic’s lockdown stage, romantic conflict is known to have exacerbated (Tadros, et al., 2022b). Slatcher and Pennebaker (2006) state that the very basic act of writing about the couple’s romantic relationship had a significant impact on the participants’ relationships with their partner. It also increased relationship stability by changing the way the partners communicated. Couples in the expressive writing condition were also more likely to utilize positive emotional words more frequently (Slatcher & Pennebaker, 2006). By just writing down thoughts and feelings about their romantic relationships, people can improve their romantic relationships. Expressive writing further has the potential to increase the relational connections of a wide range of social channels, especially for people who have little experience expressing their feelings to others (Slatcher & Pennebaker, 2006). The beauty of a well-written handwritten message is that it can convey a greater level of investment and appreciation than a simple thank you. It can be used to follow up on a conversation, to remind someone that they are not forgotten, to highlight new topics, or even to include a meaningful gift (Coleman, 2013). The future directions for research on letter writing will be explained in the following section.
Future Directions
This intervention can be utilized by various individuals, not solely those in a romantic relationship. It can be especially helpful for individuals who have suffered a loss and wish to write a letter addressed to the individual who passed away (Larsen, 2022). Creative approaches can be used to help those grieving cope with the loss of a loved one and reduce the mental health disorder impacts that coincide such as letter writing (Lander & Graham-Pole, 2009). Utilizing letter writing as an intervention with additional groups is important to determine its effectiveness with various populations. Additionally, letter writing is often viewed from a romantic partner framework; however, additional dynamics, such as sibling or parent, should be further examined to determine the nuances of those dynamics as they may differ.
Future studies should seek to determine and measure the effectiveness of letters for both the letter sender as well as the letter receiver, if there is someone receiving it. As mentioned, letter writing often stirs emotions, including guilt, shame, loss, and grief, which is important to recognize (Keenan et al., 2014; Voskanova, 2015). Thus, the letter will not be read by the deceased, and tangible “positive” outcomes are not possible. We encourage the acknowledgment of other kinds of positive impacts, such as lessened anxiety and healthy management of negative emotions. This could be achieved through utilizing a measurement scale to rate feelings and emotions during the letter writing process as well as afterwards, and then comparing. It also may be beneficial to compare the emotions of those who chose to send the letter, compared to the emotional response of those who did not choose to send, or were not able to, due to that individual being deceased or where it could cause harm to the individual to send, such as an individual sharing their sexuality and/or gender identity with their family. Comparing the effectiveness of writing letters between individuals involved in a formal romantic relationship, compared to a more casual romantic relationship, should be examined in the future.
Future research should examine therapeutic differences in electronic letters compared to paper letters (Pyle, 2006). Additionally, interviewing individuals who have engaged in letter writing would be beneficial to hear their thoughts on the process and how it may have impacted them. Letter writing could also be used by couples who have broken up and are utilizing letter writing as a means to reach out and initiate contact. A therapeutic practice with roots in narrative therapy, writing letters is a strength-based and potentially, power-regaining process. Understanding that therapeutic letter writing may not be appropriate for all groups is crucial. Instead, it is important to anticipate and accommodate every person, regardless of background, in order to assist them reach their goals in different ways.
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References
Adams, D. D. (1988). Treatment models of men who batter: A profeminist analysis. In K. Yllo & M. Bograd (Eds.), Feminist perspectives on wife abuse (pp. 176–199). Sage.
Allgood, S. M., Seedall, R. B., & Williams, R. B. (2019). Expressive writing and marital satisfaction: A writing sample analysis. Family Relations: an Interdisciplinary Journal of Applied Family Studies. https://doi.org/10.1111/fare.12416
Andrews, J., Clark, D. J., & Baird, F. (1997). Therapeutic letter writing: Creating relational case notes. The Family Journal, 5(2), 149–158. https://doi.org/10.1177/1066480797052011
AnjaBjorøy, S. M., & Nylund, D. (2016). The practice of therapeutic letter writing in narrative therapy. The Handbook of Counselling Psychology (pp. 332–348). SAGE Publications Ltd.
Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11(5), 338–346. https://doi.org/10.1192/apt.11.5.338
Brady, S. (2021, October 11). The sensitivity of boundary setting in collectivist cultures. Counseling Today. https://ct.counseling.org/2021/10/the-sensitivity-of-boundary-setting-in-collectivist-cultures/
Butler, R. (2016). Letter writing in two contexts: Facilitating stories of resistance. International Journal of Narrative Therapy & Community Work, 1, 60–69.
Christenson, J., & Miller, A. (2016). Slowing down the conversation: The use of letter writing with adolescents and young adults in residential settings. Contemporary Family Therapy: an International Journal, 38(1), 23–31. https://doi.org/10.1007/s10591-015-9368-0
Cobb, N. (2013). Fair fighting rules for couples. Calgary Marriage Couples Counselling Counsellor. Retrieved in 2022 https://www.nathancobb.com/fair-fighting-rules.html
Coleman, J. (2013). Handwritten notes are a rare commodity. They’re also more important than ever. Harvard Business Review.
Combs, G., & Freedman, J. (2012). Narrative, poststructuralism, and social justice: Current practices in narrative therapy. The Counseling Psychologist. https://doi.org/10.1177/0011000012460662
Constantin, V. (2019). Therapeutic letters within an unifying experiential intervention– A way of healing through creative writing. Case Study. Journal of Experiential Psychotherapy, 22(4), 9–16.
Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50(1), 31–48. https://doi.org/10.1177/002214650905000103. Interventions. In W. C. Nichols, M. A. Pace-Nichols, D. S. Becvar, & A. Y. Napier (Eds), Handbook of family development and intervention (pp. 235–252). Wiley.
Davidson, H., & Birmingham, C. L. (2001). Letter writing as a therapeutic tool. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Official Journal of the Italian Society for the Study of Eating Disorders (SISDCA), 6(1), 40. https://doi.org/10.1007/BF03339750
Epston, D. (2009). The legacy of letter writing as a clinical practice: Introduction to the special issue on therapeutic letters. Journal of Family Nursing, 15(1), 3–5. https://doi.org/10.1177/1074840708331150
Frederiksen, Y., O’Toole, M. S., Mehlsen, M. Y., Hauge, B., Elbaek, H. O., Zachariae, R., & Ingerslev, H. J. (2017). The effect of expressive writing intervention for infertile couples: A randomized controlled trial. Human Reproduction, 32(2), 391–402. https://doi.org/10.1093/humrep/dew320
Friedlander, M. L., Heatherington, L., & Marrs, A. L. (2000). Responding to blame in family therapy: A constructionist/narrative perspective. The American Journal of Family Therapy, 28(2), 133–146. https://doi.org/10.1080/019261800261716
Hare, A. L., Miga, E. M., & Allen, J. P. (2009). Intergenerational transmission of aggression in romantic relationships: the moderating role of attachment security. Journal of Family Psychology, 23(6), 808. https://doi.org/10.1037/a0016740
Hartman, A. (1990). Many ways of knowing. Social Work, 35(1), 3–4. https://doi.org/10.1093/sw/35.1.3
Hoffman, R. M. (2008). Letter writing: A tool for counselor educators. Journal of Creativity in Mental Health, 3(4), 345–356. https://doi.org/10.1080/15401380802529973
Hoffman, R., Hinkle, M. G., & Kress, V. W. (2010). Letter writing as an intervention in family therapy with adolescents who engage in nonsuicidal self-injury. Family Journal, 18(1), 24–30. https://doi.org/10.1177/1066480709355039
Hoffman, R. M., & Kress, V. E. (2008). Narrative therapy and non-suicidal-self-injurious behavior: Externalizing the problem and internalizing personal agency. The Journal of Humanistic Counseling, 47(2), 157–171. https://doi.org/10.1002/j.2161-1939.2008.tb00055.x
Jolly, M. (2011). What I never wanted to tell you: Therapeutic letter writing in cultural context. The Journal of Medical Humanities, 32(1), 47–59. https://doi.org/10.1007/s10912-010-9127-z
Keenan, M. J., Lumley, V. A., & Schneider, R. B. (2014). A group therapy approach to treating combat posttraumatic stress disorder: Interpersonal reconnection through letter writing. Psychotherapy, 51(4), 546–554. https://doi.org/10.1037/a0036025
Kim, C. M., Son, O., & Nam, T. J. (2019). The effect of handwriting and physical representation in computer-mediated text communication. Archives of Design Research, 32(2), 45–55. https://doi.org/10.15187/adr.2019.05.32.2.45
Kleiven, G. S., Hjeltnes, A., Råbu, M., & Moltu, C. (2020). Opening up: Clients’ inner struggles in the initial phase of therapy. Frontiers in Psychology, 11, 591146. https://doi.org/10.3389/fpsyg.2020.591146
Koebach, A., Carleial, S., Elbert, T., Schmitt, S., & Robjant, K. (2021). Treating trauma and aggression with narrative exposure therapy in former child and adult soldiers: A randomized controlled trial in Eastern DR Congo. Journal of Consulting and Clinical Psychology, 89(3), 143–155. https://doi.org/10.1037/ccp0000632
L’Abate, L. (2008). A proposal for including distance writing in couple therapy. Journal of Couple & Relationship Therapy, 7(4), 337–362. https://doi.org/10.1080/15332690802368410
Lander, D. A., & Graham-Pole, J. R. (2009). Love letters to the dead: Resurrecting an epistolary art. Omega, 58(4), 313–333. https://doi.org/10.2190/OM.58.4.d
Larsen, L. H. (2022). Letter writing as a clinical tool in grief psychotherapy. OMEGA - Journal of Death and Dying. https://doi.org/10.1177/00302228211070155
Miga, E. M., Gdula, J. A., & Allen, J. P. (2012). Fighting fair: Adaptive marital conflict strategies as predictors of future adolescent peer and romantic relationship quality. Social Development, 21(3), 443–460. https://doi.org/10.1111/j.1467-9507.2011.00636.x
Minuchin, S., & Fishman, H. C. (1981). Family therapy techniques. Harvard University Press.
Muruthi, B., McCoy, M., Chou, J., & Farnham, A. (2018). Sexual scripts and narrative therapy with older couples. American Journal of Family Therapy, 46(1), 81–95. https://doi.org/10.1080/01926187.2018.1428129
Päivinen, H., Holma, J., Karvonen, A., Kykyri, V. L., Tsatsishvili, V., Kaartinen, J., ..., & Seikkula, J. (2016). Affective arousal during blaming in couple therapy: Combining analyses of verbal discourse and physiological responses in two case studies. Contemporary Family Therapy, 38(4), 373–384. https://doi.org/10.1007/s10591-016-9393-7
Pennebaker, J. W. (2004). Writing to heal: A guided journal for recovering from trauma and upheaval. Oakland, CA: New Harbinger.
Prasko, J., Diveky, T., Mozny, P., & Sigmundova, Z. (2009). Therapeutic letters– Changing the emotional schemas using writing letters to significant caregivers. Activitas Nervosa Superior Rediviva, 51(3–4), 163–167.
Pyle, N. R. (2006). Therapeutic letters in counselling practice: Client and counsellor experiences. Canadian Journal of Counselling, 40(1), 17–31.
Rogers, S. L., Howieson, J., & Neame, C. (2018). I understand you feel that way, but I feel this way: The benefits of I-language and communicating perspective during conflict. PeerJ, 6, e4831. https://doi.org/10.7717/peerj.4831
Signs, T. L. (2015). The art of letter writing in medical family therapy. Journal of Family Psychotherapy, 26(3), 243–246. https://doi.org/10.1080/08975353.2015.1067535
Sinclair, S. L., & Monk, G. (2004). Moving beyond the blame game: Toward a discursive approach to negotiating conflict within couple relationshipS. Journal of Marital and Family Therapy, 30(3), 335–347. https://doi.org/10.1111/j.1752-0606.2004.tb01244.x
Slatcher, R. B., & Pennebaker, J. W. (2006). How do I love thee? Let me count the words: The social effects of expressive writing. Psychological Science, 17(8), 660–664. https://doi.org/10.1111/j.1467-9280.2006.01762.x
Suddeath, E. J., Kerwin, A. K., & Dugger, S. M. (2017). Narrative family therapy: Practical techniques for more effective work with couples and families. Journal of Mental Health Counseling, 39(2), 116–131. https://doi.org/10.17744/mehc.39.2.03
Tadros, E. (2021). Hierarchical privilege and power in supervision. International Journal of Systemic Therapy. https://doi.org/10.1080/08975353.2020.1809917
Tadros, E. & Owens, D. (2021). Clinical implications for culturally informed counseling with incarcerated individuals. American Journal of Family Therapy, 49(4), 344–355. https://doi.org/10.1080/01926187.2020.1813659
Tadros, E., Cappetto, M., & Aguirre, N. (2022a). Treating specific phobia fear of injury through narrative therapy post-release: A clinical case study. Journal of Forensic Psychiatry and Psychology, 33, 3. https://doi.org/10.1080/14789949.2022.2065332
Tadros, E., Cappetto, M., & Kaur, L. (2019). Treating symptoms of borderline personality disorder through narrative therapy and naltrexone. American Journal of Family Therapy, 47(2), 87–101. https://doi.org/10.1080/01926187.2019.1590787
Tadros, E., Gomez, E., & Dudek, M. (2022b). Couple connectedness in the time of COVID-19. Family Journal, 30(4), 589–595. https://doi.org/10.1177/10664807221082397
Tadros, E., Molla, E., Cappetto, M., & Finney, N. (2018). Examining somatic symptoms that mimic physical disorders through a narrative and medical family therapy lens. The American Journal of Family Therapy, 46(5), 454–469. https://doi.org/10.1080/01926187.2018.1561236
Tetley, J., Lee, D. M., Nazroo, J., & Hinchliff, S. (2016). Let’s talk about sex–what do older men and women say about their sexual relations and sexual activities? A qualitative analysis of ELSA Wave 6 data. Ageing and Society. https://doi.org/10.1017/S0144686X16001203
United States Postal Service. (2021). First-Class Mail Volume Since 1926 (Number of Pieces Mailed, to the Nearest Million). Retrieved in 2022 https://about.usps.com/who-we-are/postal-history/first-class-mail-since-1926.htm
Vidgen, A., & Williams, R. (2001). Letter-writing practices in a child and family service. Journal of Family Therapy, 2, 317–326. https://doi.org/10.1111/1467-6427.00186
Voskanova, C. (2015). A letter does not blush: In-session writing to deal with shame in brief therapy. Journal of Family Psychotherapy, 26(1), 56–61. https://doi.org/10.1080/08975353.2015.1002744
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. Norton.
Wright, J. K. (2009). Dialogical journal writing as ‘self-therapy’: ‘I matter.’ Counselling & Psychotherapy Research, 9(4), 234–240. https://doi.org/10.1080/14733140903008430
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Tadros, E., Presley, S. & Ramadan, A. Dear John: Letter Writing as a Narrative Therapy Intervention. Trends in Psychol. (2024). https://doi.org/10.1007/s43076-024-00413-z
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DOI: https://doi.org/10.1007/s43076-024-00413-z