-
>> Hi, welcome back. We are here with
Dr. Jamie Pennebaker,
-
and we're talking about expressive writing
and welcome to our second hour.
-
We talked a lot about the research base
and the history of kind of discovering
-
and figuring out that expressive writing
works, especially to help people with
-
a variety of objective outcomes,
including health measures,
-
job measures, and things related to that,
and then we're going to go back
-
and talk more about how it is that
we can think about expressive writing
-
most productively.
-
Well, welcome back Jamie.
>> It's good to be back.
-
>> (laughing) Indeed.
-
So, when we're thinking about expressive
writing, you know, one of the things
-
that I think about a lot here is sort of
what's the magic ingredient,
-
what's the mechanism of treatment
effect, do you think, for this process?
-
>> When the first studies were done,
there were all of these hypotheses on
-
what it must be, and one of them,
people were-- felt that
-
"Well, this must be some kind of
catharsis or venting."
-
And all of our analyses and various
studies showed that's not it at all,
-
it's a much more-- there are
many things going on.
-
And the other thing-- science hates this,
science wants a nice simple answer,
-
but spoilers--
>> What clinicians are (crosstalk)?
-
>> Spoiler alert! There is not a silver
bullet that explains it, that there are
-
multiple, multiple factors involved.
-
So for example, with expressive writing,
we-- there have now been these
-
various studies that show first of all
just labeling an upsetting experience
-
is important.
-
So there have been these studies
looking at brain activity,
-
and if you can just label what happens,
or just label your emotions,
-
that's beneficial.
-
A second is that writing about an
experience helps to give it some
-
structure and organization.
-
So that too is really valuable.
-
Another related one is that expressive
writing also helps to provide meaning
-
for a person.
-
And then-- and creating a narrative
seems to be beneficial.
-
But another thing that I think is really
central is that-- think about what happens
-
when you don't write, or you don't talk
about an upsetting experience.
-
You're walking down the street, and you've
had, just had a terrible interaction
-
with somebody.
-
What happens is in your mind, you think
about "Ooh, I shouldn't have said that",
-
"Ooh, I can't believe that they said that"
and then you go off in another direction.
-
Your thought patterns, very often after a
trauma, in the days and weeks afterwards,
-
are random, they're just-- they are--
>> Destroying you.
-
>> Destroying-- exactly.
>> (inaudible).
-
>> And so what writing does, it forces you
to bring together all of these aspects,
-
so you start to realize "Wow, this
upsetting experience is associated
-
"with why I'm having problems
with my spouse, this is associated with
-
"why I'm having sleep problems,
this explains why I don't
-
"have any money in the bank right now,
this..." And so you start putting--
-
>> Think of those connections
we were talking about--
-
>> You're making connections that's right.
>> You want people to be indicating, yeah.
-
>> So it's all of this. But then there
have been all of these other studies
-
looking at expressive writing, and one
was one that I particularly loved
-
that was looking at essentially
working memory or executive function.
-
And working memory, as you'll remember,
is this-- the idea of your ability to
-
keep multiple ideas in your head at once,
it's a frontal lobe phenomenon.
-
And what this research found was that
when people did expressive writing,
-
that they found enhancements,
improved working memory,
-
in the days and weeks afterwards.
>> Oh, yeah.
-
>> Now, having more working memory
does a lot of things, and it's also
-
associated with... that's one reason
I think, by the way, people do better
-
in school after writing.
>> Sure, yeah,
-
better focus and concentration.
>> That's right.
-
>> They can direct their thinking
more effectively.
-
>> That's right. And there have been
some studies showing that people
-
who are taking the SATs, or college boards
of some kind, that if they do expressive
-
writing beforehand, they do actually
better than if they don't.
-
And again, I think it's the
working memory issue.
-
And there's another thing that's also
relevant to working memory,
-
and a lot of other things, is after
people write, they also sleep better.
-
>> Ah. Good.
>> And think about
-
what we not know about sleep.
-
We know sleep is associated with
reduction in depression, we know
-
that it's associated with enhanced
immune functions, many of the things
-
that we know expressive
writing is beneficial for.
-
>> Sure, it's the quality and quantity
are related to these things, yeah.
-
>> That's exactly right.
-
So that's another factor
that feeds into this.
-
But then there's one that I found also
quite compelling. Years ago,
-
we did a study with college students,
and what we were interested in was
-
does expressive writing
change your daily behaviors?
-
Now, we had done studies and we
gave people questionnaires,
-
and one thing in my research is I'm
very suspicious of questionnaries,
-
and one of the questionnaire items
we asked was, you know,
-
"To what degree over the last
few weeks have you been able to
-
"connect with others?"
-
Nobody could answer that question,
it's a stupid question.
-
I wanted, though, to find out can we
get at that? So what we devised was a--
-
it's a method called the electronically
activated reporter, the EAR, or the ear.
-
And it was essentially a glorified tape
recorder that would come on for
-
30 seconds and go off for 12 minutes,
and we had people wear this for two days
-
before they came in to a writing study.
-
And then we had them wear this again
one month later, and what it does is
-
it just captures how much of the time
you're talking with others,
-
the degree to which you are laughing,
the kind of language that you are
-
using, so forth.
-
What we found was that people in the
experimental conditions, people who
-
wrote about their deepest thoughts
and feelings about something
-
ended up talking more with others,
laughing more with others,
-
they were more connected with others.
-
And I think this gets back to
executive function, or working memory,
-
that when you have an upsetting
experience, you are thinking about it
-
all the time.
-
You are a worse friend, because you're
just not paying attention to your friends,
-
you're not sleeping as well,
you're not doing as well at school,
-
because you're distracted--
>> You're distracted by all your thoughts.
-
>> That's exactly right.
-
And then what expressive writing does is
it helps to put this upsetting experience
-
into some kind of context, and you
just don't think about it as much.
-
And if you do think about it,
it's not as upsetting.
-
And you sleep better, and you
can connect with others better.
-
So why does it work?
-
I think all of those things in this
cascade of things, all of those things
-
help to explain the effect.
>> It's basically a form of
-
cognitive processing, clearly.
>> It very much is. It is.
-
>> And that obviously has been
shown in a lot of ways to be
-
beneficial to people in terms of
putting traumating experiences
-
and other past experiences
sort of in their place, right?
-
>> Yes, that's right.
>> It kind of helps to
-
actually put them in the past,
and they don't have to be
-
thinking about them so actively
all the time anymore.
-
>> That's right, that's right,
and a cognitive experience
-
is also an emotional experience,
and this distinction between
-
cognition and emotion, I think,
is somewhat false,
-
because the two are-- they're all
part of the same phenomenon.
-
>> Yeah, clinically we end up making
those distinctions a lot,
-
I think just mostly as a shorthand
way to kind of make life easier
-
for us as clinicians sometimes,
and kind of looking at
-
someone's emotional functioning
and their cognitive functioning.
-
Obviously those are very intertwined
in this way, and especially--
-
obviously, this is the primary basis of
all CBT, cognitive behavioral therapy,
-
is that those things are very
closely linked that way.
-
So this discussion about working memory
kind of makes me wonder about
-
the timing of these interventions,
and whether we have any kind of
-
indication of boundary conditions,
having to do with when we would
-
recommend that we not
use these techniques--
-
>> This is a critical question.
And... so there are interventions,
-
and I think clinicians worry about this
as well, if there is a major
-
trauma for a person, should you jump
right in and start doing some kind of
-
therapy immediately?
-
>> Yes, this is very dicey to us.
>> It is.
-
>> Given the evidence base these days.
>> That's right, and the data shows
-
pretty clearly, therapy-- at least
deep therapy immediately after trauma's
-
probably a bad idea.
-
And I think that includes writing.
>> We want much more naturalistic
-
social support and that kind of
thing during that time.
-
>> Yeah, that's exactly right.
-
And, you know, if you look at the data,
and this is since I started
-
doing expressive writing, I've since
moved into another world
-
doing analysis of language.
-
And look--
>> We'll have to have you back
-
to talk about it.
>> Exactly.
-
But looking at how people write
in blogs after, say, 9/11,
-
or other traumas.
-
And what you find is that people who
are able to distract themselves
-
actually do much better than people
who are really obsessing about
-
this trauma immediately afterwards.
>> Digging into it right away.
-
>> But the rule I have for expressive
writing is you should write when you
-
find that you're thinking
about a trauma too much.
-
Now, if your spouse died last week
and you're thinking about it all the time.
-
>> How would we define
when that's too much?
-
>> That's not too much,
that's completely normal.
-
If, two years later, you're thinking
about the spouse all the time,
-
that's too much.
>> Not so acceptable.
-
>> So I think you have to weigh
when-- at what point do your friends
-
not want to talk about this anymore?
-
At what point do you realize
that nobody wants to hear this,
-
or that your friends are avoiding you?
-
That's a sign you're thinking about it
too much, and that's where
-
expressive writing can be
really beneficial.
-
Now, I should also say, there are
some people immediately after trauma,
-
they need to start writing immediately.
-
Fine!
-
>> Do we know who these people are--
>> No.
-
>> I mean from a clinical perspective--
>> No, no.
-
>> So, you know, if we're doing
a crisis intervention kind of a--
-
an intervention for example,
you know, if somebody
-
runs a practice, for example, who is
very centered around crisis intervention,
-
this might not be the place where we would
suggest using this type of technique
-
as much, I'm not sure we have a way
to test who would benefit from it
-
and who wouldn't.
-
>> Well, I'll tell you what I have done,
and that is when I dealt with
-
a group like that.
-
I'll say "look, I don't recommend
writing right now, but there might be
-
"some of you here who feel as though
you would benefit from it. Try it."
-
You know-- but if you're finding that
it's not helping, try something else.
-
>> Yeah, there's that autonomy piece
again, and that sort of self-reflective
-
piece that we want people
to be engaging in.
-
That makes total sense.
-
So when we think about the ways that
this gets implemented, are there
-
any other sort of really negative effects
that can come off of this?
-
Iatrogenic effects, you know, effects
that are actually harmful to people
-
when we're attempting to help them,
other ways in which you would consider
-
this technique to be dangerous?
-
>> I've never seen it
to be dangerous.
-
I've seen some people who got
quite distressed when they were writing.
-
Now in the laboratory studies, of the,
I don't know, let's say 2,000 people
-
that I've been involved with,
I've probably seen cases of
-
maybe three cases that
were problematic.
-
One was a project-- we were dealing
with people who were self-harmers.
-
And this was-- actually, this was a
pivotal study for me, because
-
we were not reading people's writings,
and I-- but we were vague,
-
a little bit vague about it, and one
person was essentially writing,
-
you know, "I have my life, I'm going to
commit suicide" and so forth.
-
And weren't reading it--
>> And we didn't see that.
-
>> They then... she made a half-hearted
attempt in the sense that she
-
took a lot of antidepressants.
-
And then told somebody immediately.
-
So that was--
>> A cry for help attempt.
-
>> That's right, and, you know, I look
at that thinking just how stupid I was
-
not to be much more clear that we weren't
reading this, and that if she were
-
distressed, she should tell us.
>> Take to the usual things
-
that you would need to do
to communicate that type of distress.
-
But we haven't seen this to have any
sort of systematic negative effect--
-
>> Not at all.
>> On people's mood,
-
or to produce suicidal ideation where
that isn't already what the person
-
is expressing or anything
along that line certainly.
-
>> In fact, that's what's been the most
intriguing thing about this,
-
'cause in our early days, this was the
big concern for every, you know,
-
review board, and others, which was
"Oh my god, people are--
-
"You can't let someone
talk about their feelings."
-
And this was the biggest, our biggest
problem was in the medical IRBs.
-
The medical IRBs would-- you could
basically submit saying
-
"I'm doing a project, I want to
saw off people's arms,"
-
and they go "Okay."
-
And then we would say "We want people
to write about that", and they go
-
"Oh no, that might make people really..."
>> Mental health does make people
-
uncomfortable.
>> But I would say
-
looking across all of the studies
that have been done,
-
there are no major-- I've not seen any
particular people who are at risk,
-
except those people who--
>> Already at high risk.
-
>> Who are in crisis at the time.
-
>> Well these are people that obviously
from a clinical perspective,
-
if you have a client who's at high risk
of suicial ideation, other kinds of
-
similar problems, obviously we would
expect for that to be being monitored
-
in other ways that are independent
of the expressive writing technique,
-
since one of the keys I think that
Dr. Pennebaker is really
-
bringing forward to us here is that we
really don't want to review this writing.
-
And in fact, we don't want them to be
encouraged, people to be encouraged
-
to share this writing with others either.
-
So for example, if we have a group setting
in which we're actually doing
-
group therapy, and we might assign this
technique as an individual tool
-
for people to use, I don't think we would
want to encourage them to share
-
their writing with each other, would we?
-
>> Probably not. And, you know, it's--
again, I always get nervous about
-
being too, you know, because--
>> Directive.
-
>> Too directive. But one of the
early studies showed that
-
expressive writing was bad,
and I was so upset
-
by this experiment, but the project was--
turned out to be an odd one,
-
what happened was it was done in
a situation where they--
-
these were standing groups,
and in one group,
-
they wrote-- and then afterwards,
they got up and had to share--
-
read what they had written.
-
And I was thinking "Geez, that's a
terrible thing," because what
-
what writing is doing is you're writing--
think about how we share an upsetting
-
experience with another person.
-
So for example, all of us had this
experience, you know, you start to
-
tell a friend about something that was
really distressing, and you're starting
-
to talk, and you're looking at their face,
and their face is going "ahh!"
-
And so what you do is you change the
topic and you move it off in some--
-
>> Make social adjustments in terms of
what you're trying to say.
-
>> But if you're reading your writing,
you can't do that, and so therein's
-
the issue. So I often-- what I have done,
some people would call it therapy,
-
I don't call it therapy, but when I've
done work with someone who
-
wants to write, I say "I want you to
write about this, and if you want to
-
"talk to me about it, that's great,
but, you know, I don't need to
-
"read it, I don't-- and you don't
need to read it to me.
-
"You can just tell me about it."
-
>> Yeah, there you go. So obviously,
I think we're saying that our
-
patients are welcome to talk to us
about their expressive writing,
-
that it's not that we would say
"Ah, I don't want to hear about that,"
-
obviously we do, and we want to
encourage that communicative
-
relationship, but we also want to make it
clear that this writing is private,
-
so that they are able to fully unload
and to, you know, kind of engage
-
in that process the best way that
they can subjectively,
-
without truncating it for them
in some way that would
-
involve them trying to manage us,
really, and our feelings that way.
-
Fantastic.
-
So, when we think about the effect
that expressive writing has on,
-
you know, sort of-- sounds very powerful,
it sounds like something that I would
-
be very tempted to start to use
and to really encourage,
-
myself potentially as a practice,
and then also with my clients.
-
But I also know that there's only
so much change we can make
-
for people, and change is often
incremental and happens
-
in small and kind of subtle ways.
-
What would you say is sort of
the powerfulness of this technique
-
or the effect size, if you will,
if we're going to speak
-
in research terms.
>> Right.
-
So this is a-- I would call this a major
question. So it's important to remember
-
that expressive writing-- it's free.
-
You know-- so as techniques go,
this is a really low-impact
-
from a clinician's perspective, and also
from the client's perspective,
-
this is something anybody can do
in any context.
-
How effective is it?
-
I would-- in the grand effect sizes,
it's a modest effect size.
-
It doesn't work for everybody,
it's doesn't work for any one person
-
all the time.
-
It's something that you can do
any way in all-- and in different methods.
-
But don't think of this as a
panacea for everything.
-
So I guess that would be my--
for those of you out in TV land,
-
who are into statistics, the average
effect size is about 0.16.
-
And it's also important to appreciate,
there have now been, I'm guessing
-
1,000 studies done on expressive writing.
>> Or more. Or more.
-
>> And they have been-- they've been done
all over the world in every-- with every
-
kind of group you could imagine.
>> Interesting.
-
>> And sometimes it works,
sometimes it doesn't.
-
And sometimes it-- you know, it depends
a lot on the kind of measures they have.
-
But there have been five that I know of,
meta analyses, so these are
-
analyses of large groups of studies.
-
And still, this effect size of about 0.16,
it bounces around a little bit.
-
But it's generally beneficial.
>> Yeah, got it.
-
And it sounds like there's no systematic
group that we would say
-
"This never works for them, this is
not a group that we want to use
-
"this technique with."
-
We've talked about the complexities,
I think, of using this technique
-
with children and their developmental
status being the main issue there.
-
Obviously, it looks like literacy would be
involved here, can you address that
-
a little bit for us?
-
>> You know, it's funny.
-
One of our early studies looked at
the maximum security prisoners.
-
>> Interesting, yeah.
-
>> And-- you know, some of these guys
couldn't write worth a damn.
-
>> Yeah, low education level--
>> Low education level.
-
>> Low (inaudible) or writing ability.
-
>> But they-- it did work, an even though
they couldn't spell or write well,
-
they wrote incredibly powerful
stories that were beneficial.
-
And we-- occasionally in our research,
we come across groups or individuals
-
who are essentially not literate.
-
And what we have done with them
is have them just talk into
-
a tape recorder, or we've had them
try other kinds of methods.
-
So they may have had a little bit of
training with writing, but they
-
just can't write.
-
Or some, they just physically can't write.
>> Right.
-
>> And some of the methods that had
been used, one of my colleagues
-
in Mexico, for example, worked with
a Mayan group, and one of their
-
cultural traditions there are worry dolls,
and what he did was have them,
-
gave them essentially the writing
instructions, but instead of
-
writing, they talked to these little
worry dolls, and found beneficial
-
effects there.
-
>> Fascinating, so obviously the writing
in and of itself may not be the sort of
-
crucial mechanism that we were
talking about, but instead
-
is something that prompts the thinking--
>> It's the translation into words.
-
>> And relates what's happening.
>> In fact, another study that
-
I'm really proud of, this was done by
Anne Krantz, she's a dance therapist
-
in San Francisco who was getting
her PhD, and came-- and worked
-
with me for her PhD.
-
And we had people do expressive movement
in a room by themselves, you know,
-
express your most traumatic experience,
or they would do this, and then
-
they would write afterwards.
-
And then there was a control group.
-
And what we found was with the
expressive movement, people found this
-
to be wonderful, and on their
questionnaires, they say
-
"It was valuable, meaningful,
it changed my life."
-
But it had no effect on their
physical health, nor on their grades.
-
The group that changed were the
ones who did the expressive movement
-
and they also wrote.
-
And if you think of how dance
therapy works, or art therapy,
-
what happens is the person does this
expressive movement, or they
-
draw or whatever, but then
afterwards, the clinician says
-
"Tell me about that."
>> "Let's talk about this."
-
>> That's right. And I think what
happens is that therapy works--
-
that the expression is valuable,
it makes you think, but it's the words
-
that cement the changes.
-
>> That verbalizing, and whatever
mechanism of verbalizing
-
we're talking about, but the verbalizing
is sort of the key in this way.
-
>> That's right. And another issue that
I think is also important,
-
is when we put things into words,
there are different ways that
-
we can do it.
-
So talking is a good one, but there's
also-- there's the feedback.
-
And one of the things that's
always is a high risk for a person is
-
"I'm going to tell you something
so profoundly personal,
-
"and you're not going to validate me."
>> Right.
-
>> And I think people are nervous
even in therapy.
-
>> Oh, I know they're nervous
even in therapy of that,
-
and I think they even have the
experience in therapy,
-
>> That's right.
>> Sometimes, of being invalidated.
-
>> That's right. And I think all of us
have had that experience sometimes.
-
And this is where writing is good.
-
But speaking also fast, you know,
words just explode out of our mouths.
-
>> It is, it's very quick, yeah.
-
>> So you can compare, say, typing
with writing by hand.
-
Or another method that I call
finger writing.
-
And all of these-- these are kind of
different types. Expressive writing
-
with typing, so there have been
several studies comparing
-
expressive writing to typing
versus with handwriting.
-
>> Versus handwriting, yeah.
-
>> And by and large the studies
don't show much difference,
-
but if you stand back and kind of
squint at the data,
-
this is called the squint method.
-
And you kind of look and you see
some slight benefit for handwriting
-
over typing, but it's not
pretty big.
-
And if you're more comfortable
just typing...
-
>> Just do it, yeah.
-
>> I think handwriting might work a little
bit better, because it's slower.
-
And I think how quickly you write
makes a big difference.
-
>> I wonder if people slow down
over time in the process,
-
with themselves, even, as they go.
-
>> It could be.
-
I've often wondered, actually,
if you had a typewriter,
-
you had people come in, they write
either on their computer,
-
on a typewriter, you know, the old
manuals where you have to push--
-
>> Boom, boom, boom, yeah,
it's more efffort, slower there.
-
>> That that might be more beneficial.
-
>> What is finger writing,
define this for our audience.
-
>> I'm the inventor of finger writing.
-
>> (laughing) Congratulations.
-
>> No, no. So many years ago, my wife
and I were travelling in another country,
-
we were in some hotel, and I can't
remember even what the issue was,
-
but I was tossing and turning about
some issue that I was dealing with.
-
And I didn't want to get up and turn on
the light and so forth, so I just
-
got up and sat in the chair, and just
started writing in the air.
-
>> Like as though you were writing
and your finger was the pen?
-
>> That's right, that's right.
-
And I, you know, I'd go like this, and...
-
And then I started noticing that
"Wow, this works really well."
-
And then I tried writing in much
bigger letters, which I did--
-
>> Big, loopy letters.
-
>> And when you do that, you're slowing
it down even more.
-
>> Yes you are, that's the connection here
between that verbal and movement
-
and all. That's interesting.
>> That's right.
-
And so I then started doing this
in workshop, so I would have people
-
write by hand, versus they would
have one period for you to just
-
write by fingers.
-
And what I find is a lot of people
actually prefer finger writing
-
to writing by hand.
-
And I would ask people, "Well, what was
the difference?" And many people would say
-
"Well, I swear more when I'm writing
with my fingers," 'cause you know,
-
they don't want to leave--
>> More open, they're
-
leaving no trace.
>> There's no trace, exactly.
-
>> Interesting. It's like another
level of privacy, almost,
-
on the product that you're creating.
>> That's exactly right.
-
>> That's really neat (laughing).
-
>> So-- but all of these, the ultimate
goal is translating an emotional
-
experience into words.
-
And I think that is really a critical
dimension. Well in many ways,
-
I'm sure that that's a commonality
that underlies a lot of
-
effective therapies, actually.
>> Effective therapies,
-
social support.
>> Anything that helps us.
-
>> Just like religion and prayers, all of
these are is that translation process.
-
>> Often many I think meditative,
and contemplative practices
-
also involve that same type of process,
that's why it's interesting to
-
see that it's there.
-
So I wonder-- you know, we talked a lot
about sort of the, a bit of the
-
symptomatology that people might
find is eased through this process,
-
sleep problems, for example.
-
Obviously frontal lobe-related things,
if you're having a cluttered
-
working memory, that kind of thing.
-
And in my experience of this,
those symptoms overlap
-
through a lot of different kinds of
disorders that we might see
-
in clinical practice.
-
I don't think that this-- this hasn't
really been done, experimenting,
-
looking at specific diagnostic
groups so much.
-
>> Well it kind of has.
>> Yeah, so I've talked (inaudible).
-
>> In a sense-- and this is so intersting
looking at expressive writing
-
versus other methods like kind of
the official ones, CVT, ACT,
-
you know, they all have three letters.
(laughter)
-
>> Yes, DBT, we've got lots of them.
>> Expressive writing is just EW,
-
just for...
>> 'Cause you're a rebel,
-
through and through, there it is.
>> (laughing) That's right.
-
But expressive writing, because it's,
you know, because it's, there's no
-
license for it, you don't need a
certificate, you just do it.
-
And there's no money that changes
hands, there haven't been these
-
giant RCTs of 10,000 people.
>> Yes, indeed.
-
Sort of safety and efficacy
studies in that way.
-
>> That's right. And my approach is,
well, why would you want to do it?
-
I certainly-- I'm not going to do it.
>> Sure.
-
>> So what this means is it's been a--
it's kind of been a ground swell of
-
small researchers in clinical psychology,
social psychology, cognitive psychology,
-
and frankly, in anthropology,
sociology, and other areas.
-
And so you have this giant community
that has done this expressive writing,
-
and so now we have to look, so this
person-- so it's been done with
-
people awaiting surgery.
-
This is chronic pain, this one has been
done on this kind of cancer,
-
this one's been done on--
you name a disorder,
-
there are studies that have been done.
-
Does it work better for some diseases,
some people more than others?
-
You know, if you stand back and look
at it, there's just not a clear answer.
-
It seems to be generally beneficial.
-
>> Yeah. But it's not so much that we
would say this is an empirically
-
supported treatment for depression,
or for anxiety, or anything
-
along that line, but instead that this is
much more of a general technique
-
that would expect to be potentially
beneficial to anyone that's
-
carrying something around, really.
-
>> That's right. That's right, and so
depression would be the obvious one.
-
And--
>> But PTSD also,
-
and other kinds of anxiety experiences.
>> And PTSD is another one.
-
And what you see when you look at this is
it seems to work, but it's not,
-
they're not huge effect sizes,
it's very modest,
-
and I think people right in the midst
of it, so if one of these PTSD studies
-
was done right after trauma, which
means its really not PTSD,
-
it's probably not going to work.
>> You know, that's acute stress disorder.
-
>> And I think also a person in the--
right in the depths of a
-
depressive episode, I would
not recommend that.
-
>> I doubt they'd be willing to engage
in it or able to engage in it.
-
>> You know, and I wouldn't
even recommend it.
-
>> Yeah, yeah. And so this is also
something that we would think of
-
as being kind of relevant to the
therapists as well, right?
-
I mean it sounds to me like it's
probably, you know, appropriate
-
for a general population that would also
include the worriers among us,
-
the clinicians who are carrying
client data around potentially.
-
I know you and I had talked about
this separately, that there are
-
some ways that we might think about
this as a tool, possibly, also
-
for sort of processing information
as a therapist, case conceptualization,
-
thinking about how it is that a
particular patient is managing things,
-
perhaps you would write your deepest
thoughts and feelings about a patient.
-
>> I think something like that
can be really beneficial.