1. expressive writing exercise  a chance to experiment with expressive writing  see the handout description for a typical James Pennebaker set of instructions  feel free to water these down for today – for example you could just write about a minor/moderate stress (current or past)  write really digging down into your feelings and thoughts about what happened  what you write will remain entirely private to you

2. mechanisms and effects  stops the cumulative stress & vulnerability produced by constant work of inhibition  recovering/working through deeply upsetting memories encourages reassessment  increases personal sense of resilience & one’s ability to tolerate intense emotions  reduces isolation and makes sharing with others easier  reduction in intrusive memories and thoughts  improved psychological well being  improvements in immune function & physical health  reduced dependence on health professionals and other helping agencies

3. mechanisms and effects stops cumulative stress produced by constant work of inhibition:  Cole, S. W., M. E. Kemeny, et al. (1996). "Elevated physical health risk among gay men who conceal their homosexual identity." Health Psychology 15: 243 - 251.  Larson, D. G. and R. L. Chastain (1990). "Self concealment: conceptualization, measurement, and health implications." Journal of Social and Clinical Psychology 9(4): 439 - 455.  Finkenauer, C. and Rimé, B. (1998). "Keeping emotional memories secret : health and subjective wellbeing when emotions are not shared." J Health Psychology 3(1): 47 - 58.  Hunt, M. G. (1998). "The only way out is through: emotional processing and recovery after a depressing life event." Behaviour Research and Therapy 36(4): 361 - 384.

4. mechanisms and effects working through upsetting memories promotes reassessment:  Reynolds, M. & C. Brewin (1999). "Intrusive memories in depression and posttraumatic stress disorder." Behav Res Ther 37(3): 201-15.  Smyth, J., N. True, et al. (2001). "Effects of writing about traumatic experiences: the necessity for narrative structuring." Journal of Social and Clinical Psychology 20(2): 161-172..  Brewin, C. R. (2001). "A cognitive neuroscience account of posttraumatic stress disorder and its treatment." Behav Res Ther 39(4): 373-93. making “emotional” memories more “autobiographical” & promot- ing reassessment are considered key cognitive therapy interventions

5. mechanisms and effects increases personal sense of resilience & one’s ability to tolerate intense emotions: reduces isolation and makes sharing with others easier:  Hunt, M. G. (1998). "The only way out is through: emotional processing and recovery after a depressing life event." Behaviour Research and Therapy 36(4): 361-84.  Pennebaker, J., J. M. Smyth, et al. (1999). "Disclosure and health: an interview with James W Pennebaker; plus comments by various other authors." Advances in Mind-Body Medicine 15(3): 161-195.

6. information from the web go to the “good knowledge” page of www.goodmedicine.org.uk, then open “lectures & leaflets” and then ”handouts, questionnaires & other leaflets” section; look in the “life review, traumatic memories & therapeutic writing” section; see too jamie pennebaker’s work at http://homepage. psy.utexas.edu/HomePage/Faculty/ Pennebaker/Home2000/JWPhome.htm www.goodmedicine.org.ukhttp://homepage