Disclosing and Sharing Emotion: Psychological, Social and Health Consequences
James W. Pennebaker
The University of Texas at Austin
And
Emmanuelle Zech and Bernard Rimé
University of Louvain, Louvain-la-Neuve
Correspondence concerning this manuscript should be addressed to either James Pennebaker,
Department of Psychology, The University of Texas, Austin, TX 78712 USA (email:
Pennebaker@psy.utexas.edu) or to Bernard Rimé, Department of Psychology, University of
Louvain, B 1348 Louvain-la-Neuve, Belgium (email: Rime@clis.ucl.ac.be). Preparation of this
paper was made possible by a grant from the National Institutes of Health (MH-52391) and by
grants 8.4506.98 and 2.4546.97 of the Belgian National Fund for Scientific Research
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Disclosing and Sharing Emotion: Psychological, Social and Health Consequences
For the last several years, the first and the last authors have been engaged in overlapping
projects that have attempted to understand some of the social and cognitive dynamics of
emotional upheavals. Together with a large number of students and colleagues, we have
attempted to learn how people naturally talk about – and sometimes avoid talking about –
emotional events. Whereas Rimé’s laboratory has focused more on how individuals socially
share their emotions with others following an emotional event, Pennebaker and his colleagues
have developed an intervention strategy wherein individuals are encouraged to disclose
emotional upheavals.
On the surface, one would think that we had found that it is always good to talk about
your problems and, if pressed to do so, talking or writing about these problems would help you
even more. If this were true, the implications for bereavement would be clear-cut: Express your
emotions and talk about your feelings and you will be able to get on with life quickly.
If only life (and research) were this simple. As we have discovered, the picture is far
more complex. Sometimes talking about our feelings or putting them into words by way of
writing predicts better adjustment. But other times, social sharing may reflect very poor
adjustment. In this chapter, we will attempt to sort out some of the complexities of social
sharing and disclosure. We first begin by reviewing the findings on social sharing of emotion
(Rimé, Finkenauer, Luminet, Zech, & Philippot, 1998; Rimé, Philippot, Boca, & Mesquita,
1992). The second section of the chapter will then focus on disclosure interventions that have
been effective in improving health (Pennebaker, 1997a, 1997b). We conclude the chapter with
specific issues surrounding social sharing and disclosure and bereavement. At the outset, it
should be stressed that the two research areas to be described differ from one another by two
important means. First, Rimé and colleagues mainly focused on the verbalization of emotional
3
events and the effects it may have on the emotional recovery from such events. Emotional
recovery is defined as the evolution over time of the arousal still elicited when a given emotional
memory is reaccessed. Pennebaker and colleagues investigated more broadly the effects of the
disclosure of personal events (which, by definition are emotional) on physical and psychological
health. Thus, the two research areas differ in three subtle ways: the independent variable -- the
verbalization of emotion versus an event which is generally emotional; type of dependent
variable -- emotional recovery versus physical health; the mode of expression -- oral
verbalization of emotions that occurs between intimates versus written expression of emotional
events.
The Social Sharing of Emotional Experiences
Most traumas, including the death of someone close, are potentially shattering
experiences. These events can disrupt the survivors’ social, emotional, and cognitive worlds.
Although there has been frequent mention in the literature that traumatic situations cause people
to talk about their experiences (e.g., Lehman, Wortman, & Williams, 1987; Schoenberg, Carr,
Peretz, Kutscher, & Cherico, 1975), most evidence has been anecdotal. Based on some of our
earlier investigations, we originally hypothesized that the urge to talk about the experience was a
characteristic consequence not only of trauma but of every emotional experience (Rimé, 1987).
This hypothesis led us to investigate “the social sharing of emotion,” or, more specifically, the
reevocation of an emotional experience in a socially shared language with some addressee, the
latter being present at least at the symbolic level.
Basic Findings on the Social Sharing of Emotion. The first step in our research was simply to
determine when individuals talked about emotional experiences with others. Using a “recall”
procedure (e.g. Rimé, Mesquita, Philippot, & Boca, 1991), respondents were instructed to recall
a recent personal emotional episode corresponding to a specified basic emotion (e.g., joy, anger,
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fear). They then answered questions about their sharing of this episode: Did they talk about the
episode with others? With whom? How long after the emotion? How often? etc. Further studies
used research procedures intended to control for potential memory bias inherent to the recall
procedure (e.g., selection, reconstruction). In “follow-up” procedures, people were contacted
immediately after an emotional situation and were subsequently recontacted on several
occasions. In “diary” procedures, participants reported daily about the most important emotional
episode of the day. Finally, experimental studies using emotion-inducing movies of different
levels of intensity assessed the subsequent social sharing among exposed participants.
Across studies, we found that emotional experiences were shared in about 90% of the
cases (for a review, see Rimé et al., 1992). The modal pattern was for the social sharing of an
emotion to be initiated early after the episode. It occurred during the same day as the episode in
about 60% of the cases. This rate of social sharing was virtually identical for all emotions – both
positive and negative – with the exception of shame and guilt which were delayed somewhat
longer. In general, the social sharing process occurred multiple times and involved several
recipients. Recipients were typically intimates that included parents or close family members,
best friends, and/or spouse or companion. People not belonging to this circle were rarely
mentioned. Recipients varied as a function of age and gender. Among children and adolescents,
parents were by far the most frequent targets of social sharing for both males and females.
Among young adults (18-33 years), the role of family decreased markedly, especially among
males. For both genders, spouses or companions as well as best friends emerged as the most
common targets. Among adults (40-60 years), females showed a heterogeneous sharing network,
while males often reported the spouse/companion as exclusive sharing recipient.
The data indicated that the degree of social sharing surrounding a given episode was a
function of the disruptiveness of the event. That is, the more disruptive an event, the more
frequently it was shared. Laboratory studies revealed that participants exposed to a highly
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emotional movie talked more about their emotional experience than participants exposed to a
low or moderate emotional film. These findings suggested that emotional intensity needs to
exceed a certain threshold in order to elicit social sharing (Luminet, Bouts, Delie, Manstead, &
Rimé, 1999).
Other studies have investigated social sharing in different age and cultural groups, as well
as personality variables related to social sharing. One study comparing a group of younger adults
(25 to 40 years), older adults (60 to 75 years), and an elderly sample (76 to 94 years) showed that
the rate of social sharing increased with age (Rimé, Finkenauer, & Sevrin, 1995). Several
studies have investigated social sharing across cultures and have found remarkably similar social
sharing rates around the world – including people in eastern Asian countries (Rimé, Yogo, &
Pennebaker, 1996), and large samples of Japanese students (Yogo & Onoe, 1998), and of Indian
adolescents (Singh-Manoux, 1999). The data from these various studies all confirmed that
social sharing of emotion is a cross-cultural phenomenon. Yet, there exist several cultural
differences in sharing modalities.
Finally, we have conducted studies to test whether personality traits accounted for extent
of social sharing of emotion (Luminet, Zech, Rimé, & Wagner, 1999). Results indicated that
general personality dimensions such as the “Big Five” have no predictive value for the social
sharing of emotion. However, alexithymia, a very specific personality dimension concerned with
difficulties in the identification and verbalization of emotional experiences (G. J. Taylor, Bagby,
& Parker, 1997), has been found to be consistently negatively correlated with social sharing, at
least for negative events.
Social Sharing of Emotion and Emotional Recovery
Clearly, people generally share their emotional experiences with others. When the
memory of an emotional episode is accessed, the components of the corresponding emotional
reaction (i.e., physiological, sensory, experiential) are also activated (e.g., Bower, 1981, Lang,
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1983; Leventhal, 1984). That this is elicited during a social sharing situation was confirmed in
one of our laboratory studies wherein participants had first to describe a past emotional
experience and then report what they experienced when sharing (Rimé, Noël & Philippot, 1991).
Nearly all of the participants reported experiencing mental images of the emotional event as well
as accompanying feelings and bodily sensations. Although the vivid sensory feelings and images
were comparable for all types of emotions, the reactions produced different social sharing
behaviors. Not surprisingly, reporting an experience of joy was rated as more pleasant than
reporting an emotion of sadness, of fear, or of anger. However, more surprising was that
reporting fear, sadness or anger was rated by only a minority of the subjects as painful or
extremely painful. Notwithstanding the reactivation of vivid images, feelings, and bodily
sensations of a negative emotional experience, the sharing did not appear as aversive as one
would have expected. This was further confirmed by subjects’ answers to the question of
whether they would be willing to undertake the sharing of another emotional memory of the
same type as the first one. Indeed, 94 percent of the subjects gave a positive answer. These data
confirmed the paradoxical character of social sharing situations. On the one hand, social sharing
reactivates the various components of the emotion, which in the case of negative emotion,
should be experienced as aversive. On the other hand, sharing an emotion, whether positive or
negative, is a natural behavior that people do willingly.
If people are so eager to engage in a social process in which they will experience negative
affect, then they should be driven to do so by some powerful incentive. What could be the
rewards they find? Common sense offers a ready-made answer to this question. Indeed, common
sense assumes that verbalizing an emotional memory can transform it and that after
verbalization, this memory would lose a significant part of its emotional load. One of our studies
recently documented this. We found that 89% of respondents in a large sample of laypersons (N
= 1024) endorsed the view that talking about an emotional experience is relieving. Virtually no
7
one refuted this view (Zech, 2000). If this layperson belief was valid, if data could confirm that
verbalizing brings “emotional recovery” or “emotional relief,” then the paradox would clear up.
People would tolerate reexperiencing because of the final profit. We thus examined this question
in several studies (for a review, see Rimé et al., 1998).
Shared vs. secret emotional events. Of all emotions, people are least likely to share
feelings of shame or guilt (Finkenauer & Rimé, 1998a). Comparing secret and shared emotions
offered an opportunity to test the common sense view (Finkenauer & Rimé, 1998b). Participants
were asked if they could recall an important emotional life event which they kept secret. Among
373 respondents, 43% answered positively and 57% negatively. Consistent with Pennebaker
(e.g., 1989), participants who had the memory of a non-shared emotion reported a higher number
of illnesses than those who did not have such a memory. Further, we found that those who had
not shared at least one emotion scored lower on various markers of life satisfaction, including
ratings about their love life, physical appearance, financial situation, public self, and current life
situation. However, in two different studies, when shared and secret emotional episodes were
compared for the intensity of the emotion these episodes still elicited when they were
reactivated, no significant difference was observed (Finkenauer & Rimé, 1998a). Thus, the non
expression of an important emotional memory was found associated with poorer health and with
lower psychological well-being. Paradoxically, however, as compared to shared emotions,
emotional memories which were not shared were found no more no less emotionally arousing
when reaccessed at the time of the investigation. In conclusion, the layperson’s view was not
supported by these data.
Social sharing and emotional recovery. We further explored this question in a number of
studies in which we observed participants following a given emotional event. The research
design generally involved assessing (1) the initial intensity of the emotion elicited by the
episode, (2) the extent of sharing that developed after, and (3) the intensity of the emotion
8
elicited when the memory of the episode was activated later. We tested the hypothesis of a
positive correlation between the amount of social sharing after the emotional event and the
degree of emotional recovery--or the difference between (1) and (3). To our surprise, these
studies never supported the prediction that sharing an emotion would reduce the emotional load.
Our data were perfectly consistent in this regard. In sum, together with our studies on shared and
secret emotional memories, our correlational findings overwhelmingly suggested that verbalizing
an emotional experience does not contribute to emotional recovery as such.
It may be critical to consider how people socially share. That is, how do they talk when
telling others about their emotions and emotional experiences? Pennebaker and Beall (1986), for
example, observed that writing about factual aspects of an emotional episode did not affect
health variables, while writing about emotional aspects did. Experiments involving various types
of sharing were thus conducted in order to assess how far such a distinction also has
consequences when emotional recovery is the assessed variable (Zech, 1999, 2000).
In three studies, we had students interview relatives about a negative emotional event of
their recent past. In a fourth one, participants extensively shared with an experimenter the most
upsetting event of their life. In each of these four studies, different sharing conditions were
created by instructing participants to emphasize either the factual aspects of the episode, or the
feelings. Control conditions involved talking about a nonemotional topic. The emotional impact
that the shared event still had when reaccessed was assessed through several indices (e.g.,
emotional intensity of the memory, intensity of bodily sensations when thinking about the event,
intensity of action tendencies when thinking about the event, challenged basic beliefs) before the
sharing interview, immediately after, and again a couple of days after. In one of the studies,
additional assessments were conducted two months later. Contrary to expected, in each of these
studies, no effect of sharing type was found on these indices of emotional impact. But despite
these negative findings, when compared to participants in either factual sharing condition, or
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control conditions, participants in the felt emotions condition consistently rated the sharing as
being more beneficial to them in general (e.g., it was useful), as having relieved their emotions
more (e.g., made them feel good), as having helped them more cognitively (e.g., it helped in
putting order in themselves), and as being more beneficial interpersonally (e.g., they experienced
comforting behaviors from the part of the recipient). Thus, no changes were found in the impact
of the emotional memory, suggesting that sharing emotional experiences failed to alleviate the
load of the emotional memory. Nevertheless, in a paradoxical manner, participants who shared
their emotions reported that the experience was ultimately beneficial compared to the controls.
Recovered or unrecovered events. Faced repeatedly with these unexpected negative
findings regarding effects of sharing on emotional recovery, we finally wondered whether the
notion of emotional recovery on which our studies relied made sense at all. Rimé, Hayward, and
Pennebaker (1996) addressed this question. Students were asked to recall one emotional
experience they "had recovered from" and one they "had not recovered from." For each, they
rated initial and residual emotional impact, as well as initial and residual sharing. The data
showed that the two types of episodes had initially elicited a comparable emotional impact.
Consistent with our previous studies, they also failed to differ for initial sharing. Both were
shared in a very large extent in the days and weeks after they occurred. However, confirming that
the notion of “recovery” makes sense, the two types of episodes differed very markedly in their
residual emotional impact and thus yielded marked differences in the recovery index. This index
was indeed much lower for non-recovered emotional memories than for recovered emotional
memories. Moreover episodes not recovered elicited much more residual sharing than recovered
ones. We could thus conclude that the notion of emotional recovery really makes sense.
Emotional memories that people selected as "unrecovered" evidenced a stronger impact on
subjective feelings and on social behavior than was the case for emotional memories that people
selected as "recovered."
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In eight different studies we conducted, participants rated the emotional intensity felt
when remembering a recent emotional event (“residual emotional intensity”) and the extent to
which they (a) still felt the need to talk about it, and (b) still talked about it (“residual social
sharing”). The delay between the target emotional event and follow-up assessments varied from
a week (Rimé, Zech, Finkenauer, Luminet, & Dozier, 1996) to several months (e.g., Luminet,
Zech, et al., 1999), or even several years (e.g., Rimé, Finkenauer, & Sangsue, 1994).
Correlations were computed between residual emotional intensity and residual sharing for each
data set. Across all studies, we found that the higher the residual emotional intensity was, the
higher was also the residual social sharing (for a review, see Rimé et al., 1998). This confirmed
that non recovered emotional memories do surface more in sharing behaviors than recovered
ones. How can we interpret this relation? On the one hand, talking about an emotional memory
can reactivate event-related emotional feelings. On the other hand, residual event-related feelings
elicit residual sharing. Does this mean that people who have failed to recover from an emotion
keep talking about it without limits? Examining the size of the correlations revealed that in six
of our eight studies, residual emotional intensity was linked more closely to the need for sharing
than to actual residual sharing. In short, when people fail to recover from an emotional episode,
they feel the need to talk about it and they actually do so to some extent. Certain social
constraints (Pennebaker, 1993) are likely to moderate the relation between residual emotionality
and actual residual sharing. However, such constraints will at the very least leave intact people’s
needs to share. In other words, as long as an emotional memory elicits actual emotional feelings,
the person can be expected to feel the need to talk about it.
Conclusion. People who experience an emotion feel compelled to talk about it and to
share it, preferably with their intimates. They do it quite willingly, despite of the fact that the
sharing process reactivates the negative aspects of the emotional experience. A very widespread
belief exists according to which sharing an emotion should bring emotional relief. Yet, both
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correlative and experimental studies which were conducted to test the validity of this belief
consistently failed to support this world view. It does not seem that talking about an emotional
memory has a significant impact on the emotional load associated with this memory.
Nevertheless, people who share their emotions generally express the feeling that the process is
beneficial. Whereas sharing was not found to have an impact on recovery, data were supportive
of the opposite relation. Lack of recovery was markedly associated with the perpetuation of
sharing, and even more markedly with the perpetuation of the need to share.
The abundance of the null findings finally led us to accept that despite stereotypes,
socially sharing an emotion does not bring emotional relief as such. The data collected so far
strongly suggest that socially sharing an emotion cannot change the emotional memory. And
after all, it does make sense with regard to adaptation. An emotional memory carries important
information with respect to future situations. If we had the potential to alter the emotionarousing capacities of such memories by mere talking about them, such equipment would
deprive us of vital fruits of our experience (Rimé, 1999).
Social Sharing Within the Context of Bereavement.
When someone within a social network dies, members of the network are naturally drawn
together. During the grieving period – especially within the first few days or weeks – the
survivors socially share their emotions and memories with each other. Many of the discussion
topics surround the individual who died, of course, but funerals and grieving rituals often include
the social sharing of other personal and family histories. Although our work to date has not
found compelling evidence that social sharing leads to emotional recovery, our data suggested
that it may serve several other important cognitive, psychological, and social functions. In this
section, we briefly summarize the most important effects. Empirical research about them is only
at an exploratory stage. Yet, we found useful to briefly review some of these emerging functions
of the social sharing of emotion.
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Constructing and consolidating memory. The roles we have within our social networks
are not often discussed or clearly defined. One of the ironies of having someone important in
our family, friendship network, or even culture die is that we openly discuss the person, our
feelings about him or her, and become conscious of that person’s influence on us. Although we
had not originally been interested in the nature of bereavement per se, our research group
became fascinated by the strong and immediate emotional response following the death of King
Baudouin of Belgium (Finkenauer, Luminet, Gisle, van der Linden, El-Ahmadi, & Philippot,
1998). The king had unexpectedly died after a reign of 42 years. In the immediate aftermath,
rehearsal processes involving both social sharing and information seeking behavior (i.e.,
following the media) took place in the country. In our surveys of a large sample of Belgium
citizens, we found that the news of the king’s death had been socially shared at a remarkably
high rate. The sharing content focused more on the event – the news of the king’s death – than
on one’s personal circumstances when first learning about the news. Rehearsal thereby
contributed to the creation of a collective memory in the Belgian society. Yet, by socially
rehearsing the collective memory, people’s memory for personal circumstances was indirectly
strengthened, ending up in flashbulb memories.
Flashbulb memories are particularly detailed, long-lasting memories of the personal
context in which people first heard about important, shocking news (Brown & Kulik, 1977).
Social sharing thus appears as a particularly efficient means to ensure that emotional events are
not forgotten. By talking about the emotional event, people gradually construct a social narrative
and a collective memory. At the same time, they consolidate their own memory for personal
circumstances in which the event took place. Although the king’s death was undoubtedly far less
personal than a family member’s might have been, the same basic processes seemed at work.
What was observed generally fits with classic views. Indeed, authors as James (1890) or Mead
(1934) stressed that people construct reality through social relationships and particularly through
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the use of every day conversation. As far as regards bereavement, the death of a loved one
generally introduces chaos in people's personal universe, which may end up in denial and in
alteration of the sense of reality. When bereaved individuals socially share the loss of a loved
one, they contribute to give both the death itself and its consequences more reality.
Processing and completing the emotional memory. The death of a loved one very often
challenges our beliefs of a coherent, predictable, and controllable world (Janoff-Bulman, 1992;
Parkes, 1972; Marris, 1958). The overwhelming emotions which result from such challenges
often drive individuals into a state of cognitive business (e.g., Martin & Tesser, 1989). They slip
into a cycle of ruminative thinking trying unsuccessfully to figure it all out. Based on our earlier
work, we hypothesized that social sharing would help to undermine this cognitive business
cycle. This led to predict that emotional memories that were not shared would be associated with
higher cognitive needs than emotional memories that were shared.
The comparison of shared and secret memories (Finkenauer & Rimé, 1998a), indeed
revealed that secret memories elicited globally more cognitive effort than shared ones. Secret
memories were associated with (1) greater search for meaning, (2) greater efforts at
understanding what had happened, and (3) greater attempts at “putting order in what happened.”
Similar items were later included in several studies in which the memory of an emotional
experience was investigated some time after the occurrence of the event. In each of these studies,
participants also rated if they still needed to talk about this memory. In the studies, a positive
correlation was found between need for completion and need for sharing. Altogether, these data
suggest that sharing contributes to the processing of the emotional information and to the
completion of the cognitive needs which were elicited by the emotional event.
This function of social sharing is also much relevant in the context of bereavement.
Experiencing the death of a loved one (Cornwell, Nurcombe, & Stevens, 1977), often shatters
people's basic beliefs that they live in an orderly, understandable, and meaningful world (e.g.,
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Glick, Weiss, & Parkes, 1974). As a result, individuals frequently search for some meaning or
try to make sense out of their negative experiences (Bulman & Wortman, 1977; Silver &
Wortman, 1980; S. E. Taylor, 1983). Finding meaning in the loss of a loved one is thought to be
one way for dealing with and adjusting to the event (McIntosh, Silver, & Wortman, 1993).
Through the use of social sharing, people can contribute to give both the death itself and its
consequences more sense and meaning (see Nadeau, this volume).
Enhancing interpersonal relationships and social integration. Almost by definition, social
sharing is associated with more salient emotional bonds among participants of the interaction. In
a recent project, for example, we observed that when intense emotions are shared, listeners
reduced their use of verbal mediators in their responses (Christophe & Rimé, 1997). As a
substitute, they manifested nonverbal comforting behaviors, like hugging, kissing, or touching.
This suggests that the sharing of an intense emotional experience can decrease the physical
distance between two persons. The decrease of interpersonal distance can have lasting
consequences for the relationship between the sharer and the listener. In this sense, sharing
emotions may contribute to the development and maintenance of close relationships. This
observation is consistent with findings from research on self-disclosure and liking. In a metaanalytic review, Collins and Miller (1994) indeed found that people who engage in intimate
disclosures tend to be liked more than people who disclose less. Complementing this finding,
they also found that, disclosure causes people to like their listeners.
The potential contribution of the social sharing of emotion to the development and
maintenance of close relationships may be of particular importance in the context of
bereavement for several reasons. As mentioned before, emotions are very generally socially
shared with intimates such as close family members, spouse or companion, and close friends.
Losing one of them also means losing a partner for socially sharing ones emotions. This may be
particularly problematic in the case of widowers, as in our studies, male adults often reported
15
their spouse/companion to be their exclusive sharing recipient. When this occurs, widowers are
left with no sharing partner. Bereavement theories emphasize the importance of attachment and
social bonds in both the impact of the loss of the loved one (e.g., the greater the attachment to
the lost person, the higher the impact) and the way people will deal with this loss of their loved
one (e.g., Bowlby, 1980; Weiss, this volume; Shapiro, this volume; Stroebe & Schut, this
volume). Social sharing of emotion may contribute to the development of new relationships after
the loss of a sharing partner. It may also help to maintain close and satisfying relationships with
those who remain in the social network, and thus providing the bereaved person with the social
support from the family and friends.
Disclosure and Health
The social sharing findings point to an inherent puzzle that has intrigued researchers,
poets, and philosophers for generations: talking about your problems is good for you, but at the
same time, if you are talking about your problems, something is the matter with you. Stiles
(1987) simplified this conundrum by comparing talking or disclosure with the fever you get
when you are sick. The fever, he pointed out, served as an indicator that the person was sick. At
the same time, however, the fever reflected an active healing process by the body that generally
helped to heal the person. Carrying the analogy even further, if the fever continues too long –
beyond a few days – the fever is probably not effectively healing the problem and is merely
signaling the insidiousness of the underlying disease.
The importance of the social sharing literature is that it is some of the first to look at the
“fever” of social sharing of emotions in the real world under naturalistic conditions. About the
same time that some of the first social sharing research was being conducted in Europe, a
separate group in the United States was beginning to explore what happened when people were
unable or unwilling to socially share emotional upheavals. Much of this research, which was
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based on an inhibitory model, suggested that the act of inhibiting or holding back one’s thoughts,
feelings, or behaviors involved biological work that, in and of itself, was stressful. If individuals
were forced to actively inhibit over long periods of time, it was argued, the greater the
probability that they would suffer from a variety of psychosomatic diseases (for a discussion of
this model, see Pennebaker, 1989, 1997b).
Evidence for this inhibition model and stress-related disease has come from a variety of
sources. For example, Kagan, Reznick, and Snidman (1988) report that inhibited children as
young as 2-4 years old have higher resting cortisol and autonomic nervous system levels and are
more prone to colds, ear infections, and allergies, than less inhibited or shy children. Recent
work by Cole, Kemeny, Taylor, and Visscher (1996) indicates that gay men who conceal their
homosexual status are more likely to suffer from major illnesses such as cancer if they are HIVnegative and to die more quickly from AIDS if they are HIV-positive than men who are more
open about their homosexuality. In our own research, we have consistently found that not
talking about traumatic experiences is correlated with a variety of health problems among
college students and adult samples (Pennebaker & Susman, 1988). Other studies indicate that
the more bereaved individuals are able to talk about their spouses’ death, the healthier they are in
the year following the death (Pennebaker & O’Heeron, 1984).
Although our initial approach to traumatic experience and health focused on the idea of
inhibition, this view has gradually evolved to incorporate more cognitive and social factors. Not
talking about a significant emotional experience or trauma with others can certainly invoke
inhibitory processes: the active restraining of the urge to share one’s story. But, at the same
time, not sharing one’s story may produce a number of interesting cognitive side effects.
Talking with others about an important event may help the person to organize the experience and
come to terms with it. By the same token, talking with others may also clarify one’s
psychological state to others. The person’s social network, then, can make accommodations
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based on what the traumatized or bereaved person is feeling and saying. Without talking, the
traumatized individual will be less likely to come to terms with the event and will be more
socially isolated to the degree that he or she is able to connect closely with others. Most
recently, we have been examining the health and cognitive effects of translating emotional
experiences into language. Although our original work focused more on self-reports of talking,
beginning over a decade ago we began to explore the nature of writing as a form of coping.
We developed a paradigm whereby people were induced to socially share or, in our
words, to disclose their thoughts and feelings about emotional topics (Pennebaker & Beall,
1986). Returning to the fever analogy, we wanted to induce a fever (i.e., disclosure) in our
participants in order to see if it really had a healing effect.
The Disclosure Paradigm: Parameters of Writing and Talking
Since the mid-1980s, several laboratories have been exploring the value of writing or
talking about emotional experiences. Confronting deeply personal issues has been found to
promote physical health, subjective well-being, and selected adaptive behaviors. In this section,
the general findings and limitations of the disclosure paradigm are discussed. Whereas a few
studies have asked individuals to disclose personal experiences through talking, most involve
writing.
The standard laboratory writing technique has involved randomly assigning participants
to one of two or more groups. All writing groups are asked to write about assigned topics for 35 consecutive days, 15-30 minutes each day. Writing is generally done in the laboratory with no
feedback given. Those assigned to the control conditions are typically asked to write about
superficial topics, such as how they use their time. The standard instructions for those assigned
to the experimental group are a variation on the following:
For the next (three) days, I would like for you to write about your very deepest thoughts
and feeling about an extremely important emotional issue that has affected you and your
life. In your writing, I’d like you to really let go and explore your very deepest emotions
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and thoughts. You might tie your topic to your relationships with others, including
parents, lovers, friends, or relatives, to your past, your present, or your future, or to who
you have been, who you would like to be, or who you are now. You may write about
the same general issues or experiences on all days of writing or on different topics each
day. All of your writing will be completely confidential. Don’t worry about spelling,
sentence structure, or grammar. The only rule is that once you begin writing, continue
to do so until your time is up.
The writing paradigm is exceptionally powerful. Participants – from children to the
elderly, from honor students to maximum security prisoners – disclose a remarkable range and
depth of traumatic experiences. Lost loves, deaths, sexual and physical abuse incidents, and
tragic failures are common themes in all of our studies. If nothing else, the paradigm
demonstrates that when individuals are given the opportunity to disclose deeply personal aspects
of their lives, they readily do so. Even though a large number of participants report crying or
being deeply upset by the experience, the overwhelming majority report that the writing
experience was valuable and meaningful in their lives.
Effects of disclosure on outcome measures. Researchers have relied on a variety of
physical and mental health measures to evaluate the effect of writing. As discussed in several
recent reviews (e.g., Pennebaker, 1997a; Smyth, 1998), writing or talking about emotional
experiences relative to writing about superficial control topics has been found to be associated
with significant drops in physician visits from before to after writing among relatively healthy
samples. Writing and/or talking about emotional topics has also been found to influence some
immune function indices in beneficial ways, including t-helper cell growth (using a blastogenesis
procedure with the mitogen PHA), antibody response to Epstein-Barr virus, and antibody
response to hepatitis B vaccinations.
Self reports also suggest that writing about upsetting experiences, although painful in the
days of writing, produce long-term improvements in mood and indicators of well-being
compared to controls. Although a number of studies have failed to find consistent mood or selfreported distress effects, a recent meta-analysis by Smyth (1998) on written disclosure studies
19
indicates that, in general, writing about emotional topics is associated with significant
improvements in psychological well-being. The degree to which writing can affect long-term
measures of negative moods needs additional investigation.
Behavioral changes have also been found. Students who write about emotional topics
evidence improvements in grades in the months following the study. Senior professionals who
have been laid off from their jobs get new jobs more quickly after writing (Spera, Buhrfeind, &
Pennebaker, 1994). Consistent with the direct health measures, university staff members who
write about emotional topics are subsequently absent from their work at lower rates than
controls.
Interestingly, relatively few reliable changes emerge using self-reports of health-related
behaviors. That is, after writing, experimental participants do not exercise more or smoke less.
The one exception is that the study with laid off professionals found that writing reduced selfreported alcohol intake.
The studies that we have conducted represent only a portion of projects that have
demonstrated the health benefits of disclosure. Esterling, Antoni, Kumar, and Schneiderman
(1990) found that students who wrote essays conveying a great deal of emotion evidenced more
efficient immune function than those whose essays failed to reveal emotion. Consistent effects
have also been found across several studies that have examined the physiological effects of
various psychotherapies. Although not a specific test of disclosure, Spiegel, Bloom, Kraemer,
and Gottheil, (1989) found that women suffering from advanced breast cancer who were
randomly assigned to nonspecific group therapy lived, on average, 1.5 years longer than those in
an information-only control group. Mumford, Schlesinger, and Glass (1983) summarized a large
number of studies examining the links between psychotherapy and medical use. Overall, when
psychotherapy was introduced as part of health maintenance organizations within companies,
overall medical utilization and corresponding costs dropped significantly.
20
Procedural differences that affect the disclosure effects. Writing about emotional
experiences influences measures of physical and mental health. In recent years, several
investigators have attempted to define the boundary conditions of the disclosure effect. Some of
the most important findings are as follows:
Writing versus talking about traumas. Few studies have directly compared the effects of
writing alone versus talking either into a tape recorder or to a therapist. Talking to a therapist
was found to induce less negative moods in the short term than writing alone but comparable
long-term effects (Donnelly & Murray, 1991; Murray, Lamnin, & Carver, 1989). Another study
found comparable effects of talking as compared to writing on Epstein-Barr virus antibody levels
(Esterling, Antoni, Fletcher, Margulies, & Schneiderman, 1994). Murray and Segal (1994) also
found similar effects of writing and talking. Although future studies are needed to test their
comparable biological, mood, cognitive, and social effects, talking and writing about emotional
experiences are both superior to writing about superficial topics.
It should be emphasized that talking into a tape recorder or even to a therapist within the
context of a disclosure study is quite different from the ways people normally socially share or
talk with a friend about a trauma. In the context of a disclosure study, the person is not seeking
or receiving emotional support, and is not receiving concrete feedback from the listener. In that
way, disclosure studies are not related to true interactions in that there is no two-way interaction
possible. Consequently, comparisons between naturalistic talking about an emotional event and
talking into a tape recorder are simply not comparable.
Topic of disclosure. Whereas two studies have found that health effects only occur
among individuals who write about particularly traumatic experiences (Greenberg & Stone,
1992; Lutgendorf, Antoni, Kumar, and Schneiderman, 1994), most studies have found that
disclosure is more broadly beneficial. Choice of topic, however, may selectively influence the
outcome. For beginning college students, for example, writing about emotional issues about
21
coming to college influences grades more than writing about traumatic experiences (Pennebaker,
1997a). It is also of interest that a recent large-scale study by Stroebe, Stroebe, Schut, Zech, and
van den Bout (1997) on bereaved adults failed to find benefits of writing – suggesting that some
types of upheavals may benefit from writing more than others. More about writing and
bereavement will be discussed in the following section.
Length or days of writing. Different experiments have variously asked participants to
write for 1 to 5 days, ranging from consecutive days to sessions separated by a week, ranging
from 15 to 30 minutes for each writing session. In Smyth’s meta-analysis, he found that the
more days over which the experiment lapses, the stronger the effects. This effect suggests that
writing once each week over a month may be more effective than writing four times within a
single week. Self-reports of the value of writing do not distinguish shorter writing from longer
writing sessions.
Individual differences. Very few consistent personality or individual difference measures
have distinguished who does versus does not benefit from writing. Most commonly-examined
variables unrelated to outcomes include anxiety (or Negative Affectivity), and inhibition or
constraint. The one study that preselected participants on hostility found that those high in
hostility benefited more from writing than those low in hostility (Christensen & Smith, 1994). In
a recent study by Paez, Velasco, and Gonzalez (1999), individuals high in the trait of alexithymia
benefited more from writing than those low in the trait. Alexithymia is characterized by the
inability to label and understand one’s own emotional state. Finally, in the Smyth (1998) metaanalysis, males were found to benefit more than females.
The interesting pattern that is emerging from this work is that people who naturally don’t
talk about their emotional state to a great degree (men, alexithymics, and those high in hostility)
benefit more from writing about traumatic experiences than more open individuals. Extending
this logic, people should benefit more from writing about stigmatizing traumatic experiences
22
than experiences that are more socially acceptable. Consequently, among bereaved individuals,
writing might be more effective in dealing with a stigmatized death (e.g., suicide, AIDS, murder)
than if the death was expected and acceptable (e.g., cancer, heart disease).
Educational, linguistic, or cultural effects. Within the United States, the disclosure
paradigm has benefited senior professionals with advanced degrees at rates comparable to
maximum security prisoners with 6th grade education (Spera, Buhrfeind, & Pennebaker, 1994;
Richards, Beall, Seagal, & Pennebaker, in press). Among college students, we have not found
differences as a function of the students’ ethnicity or native language. The disclosure paradigm
has produced consistently positive results among Spanish-speaking residents of Mexico City,
multiple samples of adults and students in The Netherlands, and even English-speaking New
Zealand medical students.
Summary. When individuals write or talk about personally upsetting experiences,
significant health improvements have been found. The effects include both subjective and
objective markers of health and well-being. The writing disclosure phenomenon appears to
generalize across settings and several Western cultures. Future studies should however confirm
that the health and well-being effects are equivalent when talking or writing.
Implications for Bereavement: Can Writing or Talking about a Death Accelerate Coping?
Taken together, the growing body of research on disclosure strongly suggests that putting
upsetting experiences into words is associated with improved physical and mental health. By
extension, writing or talking about the death of someone close should accelerate coping. To the
degree that loss of a loved one is a form of trauma, then, we would predict that writing about it
would be associated with improved physical and mental health. Interestingly, the data on
disclosure and coping among bereaved individuals is clearly mixed. Some studies indicate that
disclosure is beneficial others find no effects of disclosure. In this section, we briefly review
23
some of the relevant studies and conclude with a discussion of when written disclosure
interventions might be most effective.
When do writing or talking interventions help in bereavement? In one of our first
correlational studies on disclosure, we found that individuals who had recently experienced the
sudden and unexpected death of a spouse due to a car accident or suicide reported being in better
health if they had talked about their spouse’s death than if they had not (Pennebaker &
O’Heeron, 1984). This study was a bit unorthodox in that health was measured by asking people
to report their health in the year before the death of their spouse and also in the year following
the death. The disclosure measures were only related to the change in reported health. In fact,
had we only looked at the post-death health measures, we would have found that disclosure was
mildly associated with worse health. For a discussion of the problem of relying on 1-time
measures of self-reports and personality measures of anxiety or neuroticism, see Watson and
Pennebaker (1989).
More persuasive are actual intervention studies. As discussed in the previous section, the
writing intervention studies require people to write about traumatic experiences for several days.
Across the multiple studies from our lab, approximately 20% of participants write about the
death of a close friend or family member. Internal analyses of these studies find that those who
write about death benefit to the same degree as people who write about other topics. On the
surface, then, people demonstrate mental and physical health benefits from writing about deathrelated topics.
A more direct test is one recently reported by Segal, Bogaard, and Chatman (in press)
with 30 elderly adults (mean age = 67.0) whose spouses had died, on average, 16 months prior to
the study. Participants, who responded to newspaper advertisements, were randomly assigned to
talk into a tape recorder on four occasions about the death of their spouse. Half of the
participants underwent the disclosure intervention within two weeks of completing the initial
24
batch of questionnaires. The control/delay treatment group participated in the disclosure
sessions approximately 6 weeks after the initial questionnaires. Overall, the authors found that
disclosure resulted in lower ratings of hopelessness, depression, and unwanted intrusive
thoughts.
Failure to find benefits from disclosure. Two research projects stand out in suggesting
that writing or talking interventions may not be beneficial – at least with everyone. The first is
an intriguing correlational project by Bonanno and his colleagues (e.g., Bonanno, this volume;
Bonanno, Keltner, Holen, & Horowitz, 1995; Bonanno, Notarius, Gunzerath, Keltner, &
Horowitz, 1998). In the study, approximately 44 adults who had faced the death of a spouse in
the previous six months were asked to come into the laboratory and, while hooked up to multiple
physiological sensors, talk about their spouse for approximately 6-10 minutes. In the studies, the
authors found that the more emotional that participants were during the interview (and, by
extension, the more they disclosed), the more poorly they were coping with their spouses death 8
months later. As suggested by our drawing on the fever analogy earlier, this study raises the
distinction between disclosure as reflecting grief versus disclosure as affecting grief.
A broad intervention study has been reported by Wolfgang Stroebe and his colleagues
(W. Stroebe et al., 1997; W. Stroebe, Stroebe, & Zech, 1996; Zech, 1999). In their study, 119
individuals, ranging in age from 23 to 76, were contacted on average 7 months after the death of
their spouse. They were randomly assigned to one of five conditions. In three conditions,
participants had to write down their reactions to the loss of their partner for half an hour on
seven consecutive days. Respondents were asked to either write about their feelings about the
loss, the facts and problems surrounding the loss, or both their feelings about, and the facts
concerning the loss. Two control groups were not asked to write about the death of their spouse.
The written essays were then mailed to the experimenters. Dependent measures were not only
self-report measures of emotional impact and mental health given before and 15 days after the
25
intervention, but also information about health problems and doctors visits based on reports from
their general practitioners for one-year period before and after the intervention (on 80 bereaved).
At follow-up, the experimental and control participants did not differ in terms of their long-term
physical health, nor on any of the measures of emotional impact and mental health.
Untangling the web: When interventions may be most helpful. As is apparent from the
above studies, the effects of disclosure on bereavement present a confusing picture. However,
closer analysis suggests the following resolutions:
1. Bereavement and loss are not unidimensional constructs. As Stroebe, Schut, &
Stroebe (1998) note, trauma and bereavement overlap but are not the same. If one’s spouse dies
suddenly and unexpectedly, the psychological, social, and cognitive effects can be different than
if the spouse dies after a long illness. A sudden death is, by definition, more likely to be defined
as traumatic. We would predict that people would benefit more from disclosure following a
traumatic loss than from a predicted one. There are two reasons for this: a) disclosure is
particularly beneficial in helping people to come to terms with chaotic, unexplained events; and
b) people find it easier to talk with their friends about more predictable losses than more
traumatic ones. Consequently, spouses who have had to face the gradual demise of their loved
one will more likely have talked with many others about death, dying, and loss. Among these
people, a disclosure intervention should have relatively minor impact.
2. Some people may benefit more from disclosure interventions than others. Recall that
Smyth (1998) reported that males are more likely to demonstrate health improvements after
writing than females. Similarly, Schut, Stroebe, and van den Bout (1997) discovered that the
ways men versus women are counseled differentially predicts positive bereavement responses.
Specifically, in this study, highly distressed bereaved persons entered a counseling program. The
interventions were done by trained experienced social workers (seven times over a period of 10
weeks). When men were asked to focus on the acceptance of emotions and emotional discharge
26
(client centered type of counseling), they were less distressed (General Health Questionnaire
scores, Goldberg & Hillier, 1979) than when asked to focus on problems that hinder the grief
process (behavior therapy type). Women showed the opposite pattern.
3. Who signs up to participate in an intervention is relevant. One of the most difficult
aspects of studying bereavement is in collecting truly random samples. The Stroebe group has
been doing this by directly contacting individuals four to eight months after the death of their
spouse. Other researchers, such as Segal et al (in press) advertised for participants in the local
newspaper. We suspect that those who seek out researchers (as in the Segal et al project) and
those who are directly contacted represent very different groups. Because most people cope
quite well with the death of a spouse – especially if it is not a traumatic death (cf., Wortman &
Silver, 1989), disclosure interventions may only be effective with those coping poorly. A
randomly selected sample, then, will be less likely to show the benefits of disclosure since most
of the participants will be in relatively good shape. A sample that self-selects to participate in a
study on spousal bereavement may, in fact, be comprised of the very people who have not had
the opportunity to work through their emotions.
4. It is important to distinguish between disclosure as an intervention versus a reflection
of grief. It is a truism within the psychopathology world that the best predictor of future
depression is a prior episode of depression. Similarly, if we have a group of bereaved spouses
six months after the death, the best predictor of their grief responses two years later will be their
current grief responses. Asking participants about their thoughts and feelings during a brief
interview is a reflection of their grief rather than an intervention about their grief. From this
perspective, the work of Bonanno and his colleagues makes perfect sense. Indeed, we find
similar effects with gay men who are dealing with the death of their lovers due to AIDS
(Pennebaker, Mayne, & Francis, 1997).
27
For a disclosure session to be an intervention, the person must actively work through an
upsetting experience. In our writing paradigm, for example, people write about emotional topics
multiple times over several days. Indeed, when we analyze the language of their writing
samples, the people who benefit most are the ones who show clear cognitive change from the
first writing session to the last. Those who are highly emotional across all four days of writing
but who do not show cognitive change do not experience any health benefits (cf., Pennebaker,
1997a).
5. Considering the type of dependent variable is essential. Whether emotional recovery,
perceived benefits, or health measures are considered is fundamental. Whereas social sharing of
emotion failed to predict beneficial effects on emotional recovery, data suggested that it opens to
a number of other important beneficial emotional, cognitive, and social effects. Writing about
emotional upheavals was also found beneficial for a variety of physical health and adaptive
behaviors, but not generally on subjective well-being or negative moods. The research so far has
mainly focused on the intrapersonal effects of social sharing or disclosure of emotion, that is the
effects on emotional recovery, well-being, and physical health. However, in natural settings, the
verbalization of emotion often implies interpersonal processes. These important social functions
of the sharing of emotion are still largely open to investigation.
Conclusions
Any emotionally upsetting experience has the potential to aggravate mental and physical
health problems. People who experience an emotion feel urged to talk about it and to share it
with others despite the fact that it reactivates the negative aspects of the emotional experience.
Although people believe that talking about their emotions will help them, the degree to which
people talk about these experiences may not help them to recover from the emotion. It is thus
debatable whether sharing bereavement-related feelings would bring emotional relief. However,
28
bereaved individuals may well feel that sharing their emotions with intimates is meaningful and
beneficial for various reasons. In particular, the development and maintenance of close
relationships that may be involved when one shares ones emotions may be a fundamental
function of social sharing of emotion. Future research should examine this closer.
On the other hand, there is now an impressive body of research to support the idea that
having people write about emotional upheavals can improve physical and psychological health.
Those who are most likely to benefit may be those who are not able to naturally talk to others
about their emotional experiences.
During bereavement, people usually work through grief naturally and do not need
intervention strategies to help them to cope with their grief. However, when bereaved
individuals continue to show extreme grief reactions several months or years after the death,
intervention may be needed. Clinicians and counselors could use natural social sharing in group
or family sessions and the writing technique as a clinical tool for people who are having the
greatest difficulty in coping with loss. These techniques may be useful for different reasons.
First, when people do not recover because they were inhibited by social constraints, this might
help to give a place where it is allowed to express ones emotions without the direct evaluation of
another person. Because the writing intervention does not need a real recipient to be present,
such tool may be particularly useful in case of social constraints. Second, in cases when
bereaved individuals continue to show extreme distress, these tools may be used as an interesting
manner to induce the stucturation of the thoughts and feelings and meaning-making. Although
one is in need to investigate whether and how beneficial changes would occur among bereaved
individuals, we are optimistic about using these low-cost effective techniques as a clinical tool
for bereaved people.
In the last decade, some theoreticians and researchers have not supported that expressing the
negative emotions associated with grief is essential for its successful resolution (Bonanno et al.,
29
1995; Bonanno & Keltner, 1997; M. S. Stroebe & Stroebe, 1991). Depending on the theoretical
view of bereavement, other tasks may equally be essential for the resolution of grief. For
example, Nadeau (this volume) argued that, in cases when factors inhibit family meaningmaking, interventions may be directed to reducing these and enhancing factors that stimulate it.
In this regard, the expression of the meanings associated with the changes in roles attached to a
given person, with the rules of the family system, and with boundaries to the social environment
may be more beneficial than the expression of only feelings. Because social sharing and writing
paradigm instructions are flexible enough, future studies could apply specific instructions related
to a specific model of bereavement.
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