How Therapeutic Writing Can Help Crisis Workers

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Each day in my work as a psych liaison nurse on a trauma unit, I was exposed to other people’s pain and suffering. Some injuries were accidental, others intentional. I worked with people who woke up after surgery as paraplegics, and a few who woke up as quadriplegics. Others woke up with colostomies or amputations. In the course of conducting psychiatric histories, I heard disturbing stories of sexual abuse, physical abuse, emotional abuse, neglect, domestic violence, poverty, and addiction. 

These stories and images seemed to take up residence in my psyche. At night, after the children were in bed, I tried to tell my husband about my day but he had no stomach for listening. One night, unable to sleep, I crawled up to our small attic room and wrote out my feelings about the day’s tragedies.

Then I could sleep. 

How writing helps

In his book, Opening Up: The Healing Power of Expressing Emotions, research psychologist James W. Pennebaker, Ph.D. describes research he conducted, asking college students to visit his lab on four consecutive days, where they spent 15 minutes writing about their deepest thoughts and feelings regarding a personal trauma.

When compared to students in a control group, those who wrote about trauma were found to experience “improved moods, a more positive outlook, and greater physical health” (p. 34), as evidenced by significantly fewer trips to the student health center and a heightened immune response.

Dr. Pennebaker’s results have been replicated many times in many different iterations by other researchers. The results are prescriptive for those of us who bear witness to other people’s traumas. 

Try it

If you’re someone who generally avoids introspection and reflection, that’s the first place to start. Here’s your first assignment:

Spend 15 minutes writing about why introspection and reflection are a waste of time. Write your thoughts about it; e.g., it’s navel gazing, it’s mental masturbation, it’s dangerous, etc.

Next, write the feelings that get conjured up in you regarding this assignment; e.g., hatred, hostility, resentment, anger, anxiety, fear, sadness, etc., followed by any memories that pop up at the same time. Don’t worry about punctuation, spelling, or grammar. Just let the words flow. 

For those of you who tend to be introspective, simply write your thoughts and feelings about something that touched you in your work with people in crisis. Write for emotional release. Write for clarification. Write freely and without self-judgment. Just write.

After you’ve written your thoughts, feelings, and memories, put your pen down. You don’t even need to be curious about what you’ve written. The simple act of writing these things down is therapeutic in and of itself.

Try it for four days, or more if you’re on a roll, and see if it makes a difference for you. It did for me. I ended up writing a book about vicarious trauma, AKA secondary stress, and although it was hard to revisit those stories, doing so was cathartic. 

Author of The Comfort Garden: Tales from the Trauma Unit, Laurie Barkin worked in psychiatry for 22 years as a staff nurse, head nurse, educator, and psych liaison nurse. For the last 17 years, she has been a UCSF consultant, providing emotional and psychological support for psychiatric staff. Laurie is a member of the Bay Area Red Cross Disaster Mental Health group and volunteers at a nursing home giving end-of-life care. Listen to this podcast for more on Laurie and her work.
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About the Author

“Every individual on this earth deserves to be treated with compassion, understanding, and the right to keep their dignity intact. This can be difficult to honor at times when someone loses control of their behavior, but that’s where Rational Detachment and not taking it personally really kicks in. What has helped me be able to do this well goes back to the first day I was introduced to Nonviolent Crisis Intervention® training. I was a participant before becoming a Certified Instructor (and before working for CPI), and over the years I have had so many opportunities to use what I learned way back then. Today, I live the skills automatically. It’s an honor to have been given those skills to live the philosophy of treating others the way I want to be treated.”