Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor
Copyright 1999 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: We appreciate Dr Plaut's comments
about the apparent beneficial effects of the writing procedure he requires
of patients. We have received many anecdotal reports of the benefits of writing
in medical practice, suggesting patients and their physicians may have an
intuitive understanding of writing's potential benefit.
Relatively little is known about the mechanism responsible for improvements
in patients who wrote about stressful experiences. Plaut may be correct in
his speculation that better medication compliance by patients who wrote explains
the effect. This might be because patients better understood their symptoms,
as suggested by Plaut, or because such an understanding reduced stress and,
in turn, improved medication compliance. Patients also may have modified other
so-called health behaviors, such as sleeping patterns, exercise, diets, smoking,
and alcohol use, in response to writing. Alternatively, neuroendocrine and
neuroimmune processes associated with cognitive states (eg, negative mood
or anxiety) could have been altered by writing.
Stone AA, Smyth JM, Hurewitz AN, Kaell A. Symptom Reduction After Writing About Stressful Experiences—Reply. JAMA. 1999;282(19):1811-1812. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-19-jbk1117