Theories , Therapies , and Taxpayers : On the Complexities of the Expressive Writing Paradigm

Although the expressive writing paradigm has generally produced positive health outcomes, a recurring puzzle concerns how and why it works. No single theory or theoretical perspective has convincingly explained its effectiveness. This may be attributable to the fact that expressive writing affects people on multiple levels—cog-nitive, emotional, social, and biological—making a single explanatory theory unlikely. In addition to addressing theory-relevant questions, researchers and therapists must now address when and with whom writing is most beneficial and, at the same time, evaluate if this (and other) intervention produces economically valuable outcomes. The Sloan and Marx review (this issue) serves as an important update to current thinking on the expressive writing paradigm. In addition to summarizing the results of a number of new writing studies, their article points to the complexities of trying to establish a single theoretical explanation to account for the effects of putting emotional thoughts into words. Writing a commentary on such an impressive article is a difficult task. I agree with virtually all of their conclusions. Indeed, their perspectives make me appreciate the writing paradigm all the more. Rather than quibble about specific findings or interpretations, it is worthwhile to underscore three points raised by the authors: the role of theory, real-world psychotherapy considerations, and the nature of outcomes within the writing research. Sloan and Marx have demonstrated on a large scale what many others have acknowledged on smaller ones: no single theory appears to account for the effectiveness of the writing paradigm. Depending on your perspective, this is either very bad, fairly good, or not very surprising news. It's bad because we have been trained to believe that psychological effects should have straightforward causal explanations. Failure to uncover a single theory could imply either that the theoretical research is sloppy or that a phenomenon is too complex to have theoretical value. The optimistic take is that the failure to find a single theory offers hope to an aspiring researcher who is more insightful than the rest of us. Most likely, there never was any reasonable hope of uncovering a single theory or mediating process to explain the power of writing. Consider the writing paradigm from a broader perspective. A wide array of people—sick and healthy, distressed and not, of all ages, genders, ethnicities, and diagnoses—are asked to write about emotional topics of their choosing for 3–5 days. Their writing topics vary from current ongoing stressors to childhood …