Writing Divorce as 'Story' May Ease Cardiovascular Effects of Stress

Divorce is a common stressor linked to an increased risk for poor long-term physical and mental health, and yet few studies have evaluated interventions that could lessen these negative health effects.

Now a new study finds that writing down your divorce experience as a story — a technique known as narrative expressive writing — may reduce the harmful cardiovascular effects of stress related to marital separation.

Participants wrote a meaningful and organized narrative of their separation experience and finished it by describing the end of their “divorce story.” According to the findings, this particular technique led to improvements in heart rate and signs of a better response to stress.

The study involved 109 adults (70 women and 39 men) who had gone through a recent marital separation. Participants were randomly assigned to complete one of three writing exercises, performed on three occasions over several days. Indicators of the body’s cardiovascular responses to stress were compared before and after the writing tasks (up to nine months after the writing).

One group performed a traditional expressive writing task, with instructions to write freely about their “strongest and deepest emotions.” In a previous study conducted by principal investigator Dr. David Sbarra, this approach actually seemed to increase separation-related emotional distress, particularly among individuals with high psychological rumination, the tendency to persistently think about one’s mood.

The second group performed a narrative expressive writing task, in which they created a “coherent and organized narrative” of their separation experience — culminating in describing an end of their “divorce story.” The third group was given an emotionally neutral writing task.

The findings show that participants assigned to narrative expressive writing had a reduction in heart rate as well as an increase in heart rate variability (HRV), which measures beat-to-beat variations in heart rate. Higher HRV reflects better functioning of the body’s parasympathetic nervous system reactions to stimuli, including stress.

“The results suggest that the ability to create a structured narrative — not just re-experiencing emotions but making meaning out of them — allows people to process their feelings in a more adaptive way, which may in turn help improve their cardiovascular health,” said psychology doctoral student Kyle J. Bourassa at the University of Arizona, Tucson.

These effects were moderate and consistent across some stressful and non-stressful laboratory tasks (such as doing mental math). Heart rate in the narrative expressive writing group was about seven beats per minute lower than the other two groups. No difference was detected in blood pressure.

In this study, there was no evidence that expressive writing increased physical stress responses in people with high degrees of psychological rumination as shown in the previous study.

“From this work, we can make two specific conclusions. First, relative to the two other conditions, narrative expressive writing caused the changes we observed in the cardiovascular biomarkers.” said Sbarra.

“This is a pretty striking result for just 60 minutes of writing over three days. Second, the effects of narrative writing on these health-relevant biomarkers is independent of adults’ self-reported emotional responses about their separation. Creating narrative may be good for the heart, so to speak, but this does not mean there [is] a corresponding improvement in psychological wellbeing.”

Since both higher heart rate and lower HRV are linked to increased health risks, narrative expressive writing might be one way to reduce the long-term health impact of divorce.

Sbarra also suggested caution in interpreting these findings. “To be clear, this study points to causal changes in health-relevant cardiovascular responding, not health outcomes per se. Further research will be needed to clarify the links between these biomarkers and the long-term health outcomes of people after divorce.”

The findings are published in Psychosomatic Medicine: Journal of Biobehavioral Medicine.

Source: Wolters Kluwer Health