Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview

most involved in the transduction of subjective experience into speech), and a simultaneous increase of activation in areas of the right hemisphere that are thought to process intense emotions and visual images. It seems the lack of a linguistic representation interferes with the development of a personal narrative and the assimilation of traumatic memories. Disclosing about the traumatic event (through writing or speech) may force the transduction of the memories from sensorylaffective components into an organized, linguistic format (Pennebaker et al., 1997). Disclosure about traumatic events may thus facilitate several processes considered central in the treatment of traumatic memory, specifically: the deconditioning of memories related to the traumatic event from affective/physiological responses, and restructuring of dissociated traumatic memories from intrusive reexperiencing of feelings and sensations into a personal, integrated narrative (Foa & Kozak, 1986). Written or verbal disclosure may be necessary as deconditioning of traumatic memories and responses will not occur merely through reexperiencing fragments of the trauma (e.g., intrusions, ruminations), as affective and sensory elements of the trauma remain separate from the rest of memory. This prevents the creation of an integrated memory that is no longer a trigger for conditioned (fear) responses.

The process of disclosure about traumatic or stressful events may produce positive effects by initially forcing the encoding of the traumatic memory into narrative language. Although initially increasing distress, it should allow a modification of the fear structure associated with the trauma, in turn facilitating the integration of the traumatic memory. A more integrated memory should lead to a reduction in intrusive reexperiencing and the attenuation of conditioned fear responses. Reductions in intrusive remembering and fear responses should ameliorate chronic hyperarousal and ultimately lead to the reduction of both psychological and physiological symptomatology.


CONCLUSIONS

Both subjective and quantitative evaluations of the evidence support the conclusion that written disclosure about traumatic or stressful events produces health benefits in both somatic and psychological domains. Several theoretical explanations of how these changes may occur were presented, focusing primarily on how disclosure may promote the formation of a structured narrative out of previously unstructured sensory fragments. This new structure should lead to the cognitive assimilation of traumatic memories and subsequent biological alterations. Developments in relating linguistic parameters to health outcomes offer exciting insight into this process. It should be noted that, although plausible, these models are speculative and must be tested in future research. The degree to which individuals improve after writing was related to several factors, suggesting that existing research cannot be easily generalized to subgroups of individuals not well-represented in existing research. As the health benefits of written disclosure in healthy people seems clear, future research needs to explore the theoretical basis of disclosure and evaluate emotional writing as a supplemental treatment for individuals who have experienced traumatic events.


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