Is it possible that allegorical journaling has wellbeing benefits that could be scientifically proven? That is definitely a question that I am committed to exploring.
Once I realised that I was feeling consistent advantages from my allegorical journaling sessions, it sparked my curiosity. I like to consider myself to be both self-aware and open to being wrong. I recognised that the benefits could be explained away by the placebo effect.
I decided to look for any research that could either support or contradict the benefits that I was feeling. Obviously, I have not found research examining what I describe as allegorical journaling. The term is one that I have coined myself, although there may well be related approaches described under different terminology that I am unaware of. The areas that I could find research on, though, relate to the emotional expression and the benefits of standard journaling.
I set about gathering all of the research that I could find. I have a commitment to the truth, so I actively searched for studies that concluded that there were benefits and also those which contradicted this. I am now in the process of meticulously going through these and analysing what they might reveal about the benefits of allegorical journaling.
One study that was of particular interest to me, though, was a study completed in 1999 which looked at the benefits of expressive writing for people with asthma and rheumatoid arthritis. It interested me as I have both. As I read the study, the results were stunning. I will summarise them here, as well as outlining the limitations of the research.
The Research
In 1999, Smyth, Stone, Hurewitz and Kaell (1999) carried out a study to explore the impact that writing about stressful experiences had on patients with asthma and rheumatoid arthritis. This study followed on from earlier research carried out by others, which indicated that writing about emotional experiences could potentially improve wellbeing, self-reported physical symptoms and healthcare utilisation. Much of this research stems from the work of James Pennebaker, which I am going to explore in more detail once I have read about it more extensively.
Smyth and his colleagues were specifically looking at whether expressive writing could influence objectively or clinically assessed disease activity in people had been diagnosed with a chronic physical illness.
Rather than simply asking whether patients reported feeling better, they examined whether changes could be detected in objective or clinically assessed measures of disease status.
About The Study
The research was a randomised, controlled trial. Participants were split into two groups – an expressive writing group and a control group. Those in the expressive writing group were told to write about the most stressful event they had experienced, and control group members were instructed to write about their plans for the day and told that this was a time management activity that might help to reduce stress. Participants were not told whether they had been allocated to the experimental or control condition.
Participants were asked to write for twenty minutes for three consecutive days, they did not discuss their writing and it was deposited anonymously in a sealed box. The exercise did not include any elements of therapy and there was not interpretation, discussion or feedback about the writing that had been completed
With asthma, they assessed the status of the condition using data from lung function tests. With rheumatoid arthritis, the data would come from indications of disease activity as determined, which would be clinically assessed by a rheumatologist. For both conditions, disease activity was measured through baseline readings and then at two weeks, two months and four months after the writing.
Findings for Asthma
Asthmatic participants had their condition assessed through spirometry. Their forced expiratory volume in one second was measured (FEV1) and this is recorded as a percentage of predicted lung function.
The results were as follows:
| Group | Baseline | Four Months |
| Expressive Writing | 63.9% | 76.3% |
| Control Group | 64.0% | 65.3% |
At the four-month follow-up, the expressive-writing group had significantly better lung function outcomes than the control group after controlling for baseline FEV1.
Interestingly, this improvement appeared relatively quickly. The expressive-writing group’s mean FEV1 showed an improvement at the first follow-up, and this was maintained until the four-month follow-up at the end of the study.
| Baseline | 63.9% |
| Two weeks | 74.1% |
| Two months | 74.7% |
| Four months | 76.3% |
Findings for Rheumatoid Arthritis
Participants with rheumatoid arthritis were evaluated differently. A rheumatologist carried out a structured clinical evaluation where disease activity was rated on a five-point scale (from asymptomatic to very severe disease).
For rheumatoid arthritis the results showed about a 28 per cent reduction in disease activity. In comparison, the control group did not improve significantly:
| Group | Baseline | Four Months |
| Expressive Writing | 1.65 | 1.19 |
| Control Group | 1.71 | 1.71 |
At the four-month follow-up, disease activity was significantly lower in the expressive-writing group than in the control group after controlling for baseline disease activity.
There was, however, an important difference. Unlike with asthma, the improvement that was identified with rheumatoid arthritis did not emerge immediately.
The expressive-writing group’s disease activity was:
| Baseline | 1.65 |
| Two Weeks | 1.90 |
| Two Months | 1.81 |
| Four Months | 1.19 |
The experimental and control groups were not significantly different at the earlier assessments. The significant difference appeared only at the four-month assessment.
This is interesting because it suggests that expressive writing did not simply produce an immediate symptom-relief effect. Whatever processes were involved may have developed over time.
Overall findings
When looking at the results as a whole, the researchers classified individual patients as improved, unchanged or worsened.
The results were as follows:
| Outcome | Expressive Writing Group | Control Group |
| Improved | 47.1% | 24.3% |
| No significant change | 48.6% | 54.1% |
| Worsened | 4.3% | 21.6% |
In short, about twice as many people receiving expressive writing experienced a clinically meaningful improvement in their disease activity when compared with people completing the neutral writing task.
Although these results are undoubtedly exciting, it is important not to look at the other side of the coin.
More than half of the expressive-writing participants did not show a clinically significant improvement. This means that any claim we make about the benefits of expressive writing are not universal. It is very possible that some people will not experience any benefits at all.
Limitations
The research had several limitations, and it would be dishonest of me not to summarise these here.
The study was based on a relatively small sample size of only 112 participants, with only 107 of these completing the whole study. It would be interesting to see if these outcomes could be replicated across a much larger group.
Participants in the study were people who had volunteered for a writing study – so were likely to be people who are more comfortable with writing than the general population. People who are comfortable with writing might also find self-expression easier and this might have implications for their mental health.
People with diagnosed psychiatric disorders or receiving psychotherapy were excluded from the study, so it is impossible to know how the results would translate to those with the most serious mental health challenges.
Follow-up was very limited. The final assessment was 4 months after the writing tasks were completed. Therefore, the long-term benefits (or otherwise) are unknown.
Probably the most significant limitation was that the study did not explore what specific elements of expressive writing had an impact. The authors discussed several possible psychological and physiological pathways. More broadly, the expressive-writing literature has proposed mechanisms including:
- emotional disclosure
- confronting avoided memories
- reducing emotional inhibition
- narrative organisation
- meaning-making
- cognitive restructuring
- stress reduction
- physiological changes
Finally, it is important to note that this study involved people writing directly about their experiences, not indirectly as with allegorical journaling. We have no way of knowing whether interpreting these experiences through metaphor and story would reduce or increase the benefits found.
What Implications Does This Have for Allegorical Journaling?
I am cautious about making any claims, as it would be irresponsible to claim that allegorical journaling has any therapeutic benefits without a detailed scientific study of this in its own right. However, I am interested in exploring the potential implications.
The study indicates that writing about personally stressful experiences produced better clinical outcomes than writing about emotionally neutral material. With allegorical journaling, the person transforms an emotionally significant experience into a symbolic narrative. This type of writing shares an important characteristic with the expressive writing that was explored in this study, as both involve writing about a personally meaningful experience. This raises the possibility that some of the processes involved in expressive writing might also be present in allegorical journaling, although we cannot assume that the two approaches would produce similar benefits.
One possible explanation for the findings, is that putting highly stressful experiences into words supports emotional processing. Instead of suppressing or avoiding difficult experiences, the individual confronts them directly.
With allegorical journaling, these experiences are still confronted, but through symbolism and story rather than recalling the experience directly. Without knowing which precise mechanisms within expressive writing are the ones that provide the benefits, it is difficult to know whether allegorical journaling replicates these processes or side-steps some of the benefits. Equally, it might offer advantages that traditional expressive writing may not offer. This would be really interesting to explore in more detail.
One of the most interesting interpretations of the research is that the benefits of expressive writing may arise because writing transforms experience.
An emotionally difficult experience may initially exist as a mixture of:
- memories
- sensations
- emotions
- images
- fragmented thoughts
- unresolved questions
- conflicting interpretations.
Expressive writing requires these experiences to be chosen, ordered and represented in words. Allegorical journaling takes this a step further by transforming them into a symbolic narrative. However, we do not know whether this additional step strengthens or weakens the effect.
Whereas traditional expressive writing generally encourages people to approach the stressful experience directly, allegorical journaling introduces an additional interpretive layer.
If the benefit comes from directly confronting avoided emotional material, it could be argued that allegorical journaling allows people to avoid the issues they need to confront. However, another possibility is that allegory permits people to approach difficult material indirectly but still meaningfully.
The writer is not necessarily avoiding the stressful material because the allegory still represents it, but does the distance that allegorical journaling offers help or hinder? Could that distance make difficult experiences easier to approach and explore, or could it reduce some of the processes that make expressive writing beneficial?
These questions are definitely something that I would like to explore further.
My Experience
From a personal point of view, my own health has improved since I started allegorical journaling. I realised that I had not even considered the benefits to physical health, only emotional wellbeing. My health improvements can be demonstrated by the results of medical tests which have been carried out by two separate medical teams in different hospitals. However, I am cautious to draw any conclusions from this as I have also had some minor medication changes during this time period which could well have had an impact. What I can say, though, is that my health improvements during this time have been more significant in the last 18 months when I have been doing allegorical journaling regularly than in the previous 20 or so years.
Whether the benefits can be scientifically proven or not, allegorical journaling is definitely contributing to my overall wellbeing so it is something I will continue to do.
Reference
Smyth, J. M., Stone, A. A., Hurewitz, A. and Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. JAMA, 281(14), 1304–1309.
You can read the original study here: