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November 17, 1999

Symptom Reduction After Writing About Stressful Experiences—Reply

Author Affiliations

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(19):1811-1812. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-19-jbk1117

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.

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