In this episode, the podcast explores a specific four-day writing protocol backed by scientific studies that greatly enhances immediate and long-term health, focusing on its implementation and the impact it has on neuroplasticity and brain function, ultimately improving physical health, immune function, sleep quality, pain management, anxiety reduction, and trauma healing. This episode appeals to individuals seeking effective science-supported protocols for better mental and physical well-being.
Andrew Huberman, a professor of neurobiology and ophthalmology at Stanford School of Medicine, focuses on a specific form of journaling which is backed by over 200 peer-reviewed studies in quality journals. This journaling method is not widely recognized despite its significant impact on improving mental and physical health. The benefits include lowering anxiety, enhancing sleep quality, boosting immunity against diseases like colds and flu, reducing symptoms of autoimmune disorders such as arthritis and lupus, and providing relief for fibromyalgia. This journaling method also improves memory and decision-making skills.
Despite its effectiveness, this journaling method is relatively unknown outside the fields of psychology and psychiatry. Huberman first learned about it from Dr. David Spiegel, the associate chair of Psychiatry at Stanford School of Medicine. The research showing the power of this specific journaling method surprised Huberman due to the overwhelmingly positive impact it can have.
What makes this protocol remarkable is that it requires a relatively small amount of time. It can be completed in one week or across one month and never done again while still providing lasting positive benefits for both body and mind. To fully benefit from this protocol, it is important to understand its specifics to apply it effectively. Furthermore, there is published scientific research explaining why and how this protocol is so effective for mental and physical health.
Dr. James Pennebaker, a psychology professor at Southern Methodist University before moving to the University of Texas Austin, researched a transformative form of journaling and its positive impacts on mental and physical health. His studies began in the mid-80s, with the first manuscript about this form of journaling published in 1986. While others had used this form of journaling before, Pennebaker was credited with attaching measurements to the specific types of changes that occurred in people when they journaled in this particular way and developing a precise protocol.
Pennebaker meticulously determined how long the method should be carried out and what exact forms of change occurred in the body and mind. He explored the method in students, veterans, the elderly, children, and more. The scientific rigor and attention to detail contributed to the protocol’s power.
The 1986 study invited undergraduate students into a university laboratory. They were asked to spend 15 to 30 minutes writing about their most difficult or traumatic life experience. They were instructed to write for the entire time without stopping, and that nobody but themselves would see what was written; they could even destroy their work after completion.
The key instructions for this journaling method are: to recall and write about one’s most difficult or traumatic life experience; to write for 15 to 30 minutes; and to keep writing for the entire time without pausing unless emotionally or physically unable. The focus is not on accurate grammar or spelling but on tapping into negatively charged memories from their past.
The environment for writing should be quiet and undisturbed. While the original study had participants write by hand, subsequent studies have shown that the positive effects are the same whether one writes by hand or types on a word processor.
Expressive writing is a powerful tool that has been examined in over 200 peer-reviewed studies. The initial protocol, provided by Pennebaker and colleagues, involves writing about something that an individual is excessively thinking or worrying about. This could also include events that the person has been avoiding thinking about, disturbing dreams, or matters affecting their life in an unhealthy way. It could relate to emotional states, inability to calm down, rumination, compulsive thoughts, addictive behaviors, or specific traumas affecting the body and mind.
The specific instructions given are to write down the deepest emotions and thoughts related to the most upsetting experience in one’s life. It encourages exploring feelings and thoughts and linking this experience to childhood, relationships with parents or siblings, loved ones, career, or schooling. It asks how this experience relates to who the person has become, who they were in the past, and who they want to become.
Even if a person hasn’t had a traumatic experience, they can write about major conflicts or stressors or the most dramatic or stressful experience they’ve ever had. After considering what to write about, subjects start writing with a timer set for 15 to 30 minutes. There are no significant differences between 15 minute and 30 minute writing blocks regarding their positive impact on mental and physical health.
However, for some people and their particular experiences, 15 minutes might be too brief to capture all thoughts and feelings; thus they may need up to 30 minutes. Subjects can stop before the 30-minute period is over or restrict themselves to 15 minutes and try to get out as much as possible in that time. The duration doesn’t significantly influence the outcome according to data.
The writing protocol being detailed is a distinct form of journaling, unlike morning notes or gratitude journaling. Morning notes are often used by writers to clear mental clutter by writing a stream of consciousness for the first 5 to 30 minutes every morning. This helps prepare for the day and potentially other forms of writing. On the other hand, gratitude journaling focuses on expressing thankfulness, but this protocol does not necessarily involve writing about things one is grateful for. Instead, it involves writing about extremely unfortunate events and negative emotions.
This form of journaling also differs from diary-type journaling, which involves recording daily life events. Many people keep journals regularly, including the speaker who has stacks of journals dating back to the early ’90s. These diary entries provide updates about recent events, hopes, and challenges. Reading these old entries proves to be an interesting exercise with moments of both cringe and smiles. The speaker emphasizes that these entries are kept private, meant only for personal reading.
The autobiographical approach to journaling that the speaker has been practicing is significantly different from this protocol aimed at improving mental and physical health. However, it doesn’t undermine the usefulness of gratitude journaling or autobiographical daily entries. Data supports that gratitude journaling can be beneficial for body and mind in numerous ways such as improving general happiness states, reducing anxiety, and enhancing relationships.
Consecutive writing bouts, a tool explored in depth by Penna Baker and his colleagues, require individuals to write continuously for 15 to 30 minutes about one of the most difficult experiences of their life. This process is typically repeated four times, often on four consecutive days. The original research conducted on this practice involved subjects, ranging from students to veterans, coming to the lab to write about their most challenging experience for 15 to 30 minutes each day over four days.
However, variations of the protocol have been tested, where individuals would choose one day per week (not necessarily the same day each week) to write about their most difficult experience. This would be repeated once a week for a month or any four-week period. The aim of this intense exercise is to confront and process traumatic or stressful narratives that are stored within our nervous systems.
The term ‘trauma’ is frequently used to describe various distressing experiences. However, Dr Paul kti, a medical doctor and psychiatrist who has extensively studied trauma, defines it as an experience or series of experiences that modify our brain and neural circuitry in ways that negatively impact our emotional, behavioural or cognitive functioning going forward. By this definition, many people likely carry some form of trauma in their nervous systems.
The consecutive writing bouts exercise is an intense but short-term protocol designed to help individuals confront and process these difficult experiences. While it may not feel good initially – with participants often feeling distraught, anxious, or as though they’ve run a mental marathon – it’s designed to bring about positive shifts in mental and physical health. It’s important for those practicing this method to allow time post-writing (approximately 10 minutes) for quiet reflection and calming down before re-entering daily living activities.
Journaling about distressing experiences can evoke sadness, anxiety, frustration, anger, and other emotions. Notably, people who engage in this journaling protocol tend to categorize into two groups termed as low expressors and high expressors. These terms have no relation to introversion and extroversion, which is a common misconception.
Low expressors use less descriptive language in their writing and exhibit less emotional response during the initial writing session. Their physiological measurements show they are relatively more calm and less distressed while writing about stressful events in their lives. This is demonstrated through lower increases in cortisol levels and fewer changes in heart rate and blood pressure.
On the other hand, high expressors utilize more negative language to describe their emotions regarding negative experiences. Physiologically, they exhibit higher levels of distress during the first writing session, as indicated by higher blood pressure, heart rate, and cortisol levels.
Interestingly, low expressors become increasingly distressed as the writing exercise progresses from day two onwards while high expressors experience a significant decrease in distress over the same period.
Despite these differences, both low expressors and high expressors benefit from the journaling protocol. Three weeks, three months, and even years after starting the protocol, both groups report experiencing significantly less distress and baseline stress levels than before they started journaling. Thus, it’s best to use the form of writing that feels most natural and accurately communicates the impact of the negative experience.
Two groups, the low expressors and high expressors, play a significant role in the writing protocol because some individuals are quite adept at expressing their emotions in writing and speech. A study by Pennebaker and his colleagues focused on how the language patterns used in daily speech and writing reflect people’s underlying emotional tone and state. This study also examined how specific words used in writing and speech can impact our emotional state.
The research titled “Natural Emotion Vocabularies as Windows on Stress and Well-being” delves into people’s natural language usage patterns. It was found that individuals who have an extensive knowledge of negative words that describe negative emotions often have a lower affect or negative emotional state, compared to those who know more vocabulary words related to positive emotions. For instance, someone who knows four times more words related to negative emotions tends to exhibit higher levels of depression and anxiety compared to someone who knows more words related to positive emotions.
However, it was not always this straightforward. The same study also looked at the word patterns people naturally use in spoken or written speech. It was found that individuals who frequently use negative words tend to have more negative emotional states. Conversely, those who commonly use words describing positive emotional states tend to experience more positive emotions. This was related to both mental and physical metrics of negative and positive emotions.
This result is significant because it highlights that our choice of vocabulary on a regular basis is more important than our knowledge of vocabulary words. When embarking on a writing protocol of four sessions lasting 15-30 minutes each, it is advised not to monitor your writing but instead focus on expressing freely without worrying about grammar or spelling. After a week or more, you can review what was written, paying careful attention to the number of negative or positive words used.
The patterns of language use from the first to the fourth entry often shift dramatically. By the fourth entry, even though individuals are still writing about the same negative experience, they tend to use fewer negative words and more positive words to describe their recollection and experience of that negative event.
Pen Baker and colleagues suggest three key elements to incorporate when writing about a difficult experience. The first is to include facts about the event. This might involve detailing what specifically occurred or, alternatively, what did not happen that contributed to the hardship. Secondly, it’s essential to write about the emotions experienced during the event and those being felt in the present moment. The third point is to establish any connections that come to mind between the negative experience and anything happening currently, in the past, or planned for the future. These links may be directly related to the traumatic or stressful episode or more obscure connections.
The importance of writing out these connections in full sentences is emphasized, despite grammar or spelling imperfections. This method aims to engage with something distressing that resides within the nervous system and is causing a negative impact. It’s crucial not to monitor word choice too closely during this process—this isn’t meant for others’ eyes but serves as a personal tool for processing difficult experiences.
There are significant benefits associated with this writing protocol when effectively executed. When narratives of previous negative experiences are not worked through, they can have lasting effects. However, putting these experiences into words can lead to numerous positive outcomes. These include neural changes, termed neuroplasticity (the literal rewiring of neural connections), and psychological benefits such as reduced anxiety, improved mood, improved sleep, and enhanced immune function. These outcomes are achievable through four sessions of 15-30 minutes each dedicated to this writing exercise.
Positive mental and physical changes are observed in individuals who engage in a specific writing exercise, according to over 200 peer-reviewed studies. This exercise involves four bouts of writing, which produces significant and long-lasting physical shifts. Although it cannot completely cure major forms of depression or post-traumatic stress disorder, it helps reduce depressive symptoms and PTSD symptoms considerably.
The writing protocol has also demonstrated significant improvements in other health metrics. Studies have shown that people suffering from chronic anxiety, insomnia, arthritis, undergoing cancer treatment, or having autoimmune disorders like Lupus, report significantly improved symptoms after completing the protocol. Similarly, those with fibromyalgia, a chronic pain condition, have shown significant improvement in symptomology, including reduced chronic pain. People suffering from irritable bowel syndrome (IBS) have also achieved some degree of symptom relief.
All of these studies compared individuals who followed this writing protocol to a control group. The control group also engaged in writing for 15 to 30 minutes but wrote about their recent activities or future plans. Despite the similar time spent on writing and the equivalent number of words written on average, the experimental group experienced statistically significant positive mental and physical effects.
The strength of this protocol is its ability to isolate one variable – the emotional content related to the writing – while keeping other factors constant. This is different from typical physical exercise studies where it’s challenging to find a control group that provides equivalent time and effort but differs on one variable such as heart rate.
The specific journaling protocol may seem conventional but is highly unusual due to its focus on writing about distressing or traumatic experiences. The dramatic shift in health across a broad range of dimensions following this protocol occurs not only in people suffering from certain conditions but also those without any specific conditions. The physiological processes that explain these incredible psychological and physical positive shifts are yet to be fully understood.
Expressive writing can have positive effects on both mental and physical health, as evidenced by over 200 peer-reviewed studies. Improvements include reductions in autoimmune conditions, anxiety, and enhancements in sleep patterns. These changes are not attributed to a single factor but a spectrum of physiological alterations.
One significant study, conducted by James Pennebaker among others, delved into how writing about traumatic or stressful events can impact immune function. Subjects were asked to follow a specific writing protocol, while their blood was drawn before and after the writing sessions – 15 weeks prior to the study and six weeks into it. The study included high-disclosure participants who revealed a lot about their traumatic experiences, low-disclosure participants who revealed less, and a control group who journaled without discussing any trauma.
The blood samples were used to isolate T-lymphocytes, essential components of the immune system also known as white blood cells. These cells are created in the bone marrow and matured in the thymus, an organ behind the sternum. T-lymphocytes combat bacterial, viral, and fungal infections.
In the study, these isolated T-lymphocytes were exposed to different concentrations of Concanavalin A – a substance that activates T-lymphocytes and mimics an infection – in a dish. The results showed that those who followed the expressive writing protocol experienced greater T-lymphocyte activation in response to the Concanavalin A challenge compared to those who wrote about non-stressful topics. Furthermore, high-disclosers experienced more immune activation than low-disclosers.
This landmark study highlights the field of psychoneuroimmunology – the interplay between emotions and physical responses – which has been recognized for over 30 years but only widely accepted in scientific and medical communities in recent years.
James Pennebaker’s interest in this field stemmed from his personal experience with asthma that seemed to be influenced by his emotional state. His research, however, took a different approach from most studies in psychoneuroimmunology. Instead of focusing on the negative physical outcomes of chronic stress, he explored how deliberately inducing a negative experience through expressive writing could lead to positive physical health outcomes, such as improved immune system function.
The intriguing question arising from this is what exactly happens during and after these writing episodes that leads to such significant health improvements. The answer seems to lie in the realm of the nervous system and its ability to rewire itself – neuroplasticity – in response to experiences.
The transcript discusses the mechanistic level changes that allow people to achieve long-lasting positive shifts in mental and physical health through writing about traumatic or stressful experiences. The key mechanism behind this process is centered around the concept of neuroplasticity, which is our nervous system’s ability to change in response to experience. Neuroplasticity in childhood occurs passively, with exposure to experiences reshaping the brain in a way that can be long-lasting.
The nervous system serves as a predictive machine, making assumptions about what will happen next based on past experiences. This is achieved by creating a map of experiences during childhood, which then guides predictions and responses in the future. Recounting a stressful or traumatic event taps into this neural map or schema, involving the facts of the experience, how it made you feel at the time and now, and any links or associations between what happened and anything else.
Traumatic events, addictions, compulsive behaviors, negative habitual behaviors, and states like chronic stress and anxiety usually involve certain components of our nervous system being less engaged than they would be under healthy conditions. While there are many different brain centers and networks involved in these conditions, one commonality is that traumatic or stressful experiences often result in reduced activity in the prefrontal cortex—the area just behind our forehead involved in planning and assessing outcomes—and increased activity in subcortical structures involved in functions like aggression, temperature regulation, sleep-wake cycles, and threat detection.
The prefrontal cortex is also associated with our self-concept of identity—who we are, what we value, what motivates our decisions—which plays a role in forming a coherent narrative of past events, present circumstances, and potential future scenarios. This understanding of the prefrontal cortex’s role provides a brief top-level comparison to some subcortical structure functions.
Neuroimaging studies, particularly by the Liberman Laboratory at the University of California Los Angeles, reveal that recounting stressful or traumatic events reduces activity in the prefrontal cortex compared to when people recall less stressful events. Simultaneously, subcortical structures increase their activity when recalling traumatic experiences.
Revisiting stressful and traumatic events in a structured way, as in journaling, initially results in a less structured narrative. However, the structure and coherence of the narrative improve with each subsequent writing bout. This process involves delving deeper into the recollection of the experience rather than remaining on a superficial level.
Despite revisiting distressing events which may heighten levels of distress, two things occur. One group tends to disclose less at the beginning, using fewer emotional words and sharing less about their experience. Over time, their sharing increases while another group decreases their emotional expression with each writing session. In both cases, the coherence of the narrative or story-like structure increases from the first to fourth writing bout.
This exercise is crucial because it involves increasing the amount of truth-telling. This includes facts about what happened or didn’t happen, how it made you feel – information only you can factually report since only you can truly know your feelings. It also involves identifying connections between different experiences that are coming to mind.
Writing about these experiences is indeed distressing but based on neuroimaging data, it elevates baseline levels of activity in key areas of the prefrontal cortex over time. It is also associated with improvements in symptoms around trauma and other stressful events. The truth-telling component is vital because your truth about these experiences is indeed your own. The actual event or events cannot be changed but your narrative about those events plays a significant role in how you experience ongoing distress from or relief from those experiences.
Reporting distressing events, which can initially be stressful, provides relief from that stress over time. This is counterintuitive as it’s known that being under conditions of duress or trauma reduces activity in the prefrontal cortex. However, recalling traumatic and stressful events in highly emotional and negative ways actually increases ongoing activity in the prefrontal cortex.
Neuroplasticity during development is a passive process. The brain changes according to what we are exposed to, allowing us to predict the future more reliably. From late teens or early adulthood all the way up to old age, neuroplasticity is created when the nervous system goes into atypical states compared to our normal waking states. One of the key triggers for neuroplasticity is high levels of dopamine, epinephrine, and norepinephrine in our brain and body. This creates an autonomic nervous system shift where we have elevated heart rate, distress, and high degrees of emotionality. This uncomfortable state signals to the neural tissue that changes need to be made. The actual rewiring occurs during deep sleep and states such as non-sleep deep rest.
Though it seems illogical, revisiting a traumatic event in detail can provide relief from that experience and create positive mental and physical shifts. Two concepts have been explored in the Psychology and Neuroscience literature over the last decade: first, extremely stressful and traumatic experiences reduce activity in the prefrontal cortex which leads to confusion about responsibility and a lack of coherence between our bodily state and what we’re thinking about that experience; second, when people truthfully narrate a coherent structure about their experiences, levels of activity in their prefrontal cortex increase – leading to neuroplasticity of these prefrontal cortical structures which are also involved in regulating the activity of subcortical structures like the hypothalamus. Thus, increasing understanding of an event allows better regulation of emotional responses both immediately and moving forward.
One of the key experiments linking prefrontal brain activity to truth-telling was published in the Proceedings of the National Academy of Sciences under the title “Increasing Honesty in Humans with Non-Invasive Brain Stimulation”. In this study, subjects participated in a game where they rolled dice and reported whether the result matched a number shown on a screen. If it did, they received a monetary reward of nine Swiss Francs (approximately $9-$10). The game was designed so that there could only be a correct match 50% of the time.
However, players reported a match 68% of the time, indicating dishonesty in their reporting. Neuroimaging studies have shown that lying results in increased activity in certain areas of the frontal cortex, but primarily causes a reduction in prefrontal cortex activity, particularly in specific subcompartments.
The experiment used non-invasive brain stimulation (transcranial magnetic stimulation) to either inhibit or stimulate brain activity. The researchers found that when they stimulated a specific area of the prefrontal cortex (the dorsal lateral prefrontal cortex), people’s honesty increased. The frequency of correct matches dropped from 68% to 50%, indicating more accurate reporting.
This suggests that stimulating this area of the prefrontal cortex can make people more honest, even if previously they were only mildly dishonest or dishonest under certain conditions. While this experiment was highly controlled and different from everyday situations, subsequent studies have shown that telling the truth increases activity in prefrontal cortex and this increase persists afterwards due to neuroplasticity.
The hypothesis with most supporting evidence is that when people accurately report an experience, even a stressful or traumatic one, repeated activation of the prefrontal cortex creates a more coherent understanding of what happened. This can potentially resolve underlying stress and confusion about who’s responsible for the event. The dorsal lateral prefrontal cortex is responsible for accurate reporting not just of traumas and stressful events, but of all sorts of other things.
There is growing consensus among researchers that recounting a traumatic or stressful event can lead to positive shifts in immune system function. It appears counterintuitive at first, but the body and brain are linked through the nervous system. When the prefrontal cortex organizes its understanding of why our autonomic nervous system was so active, the autonomic nervous system becomes less likely to be active when it’s not supposed to. This could explain reductions in anxiety, improvements in sleep, and reductions in insomnia.
The nervous system and the immune system have direct communication, which although often not discussed, impacts both the brain and the body. The brain has neural circuits that can communicate with structures like the spleen and bone marrow. An article in the journal Nature acknowledges that while immunology, brain science, and psychology have existed as separate silos until now, it’s clear that the nervous system is the connection between all these components of brain and body.
A writing protocol could positively impact the immune system and symptoms like Fibromyalgia by considering the prefrontal cortex as a flexible seat of our cognition about our self-representation and when certain elements within our brain and body ought to be activated. Negative symptomology of stressful events and traumas is often about disarrayed activation of wakefulness during sleep, leading to sleep disturbances, elevated heart rate, panic attacks, anxiety etc.
Writing for 15-30 minutes about a stressful or traumatic episode could induce positive shifts in mental and physical health. The activation and neuroplasticity of the prefrontal cortex seems to be one of the most logical mechanisms behind this phenomenon. When you write about your truth, about the facts of an experience, your emotions related to that experience, and any connections you draw around that experience, it stimulates neuroplasticity.
Data indicates that people’s progression through therapies for depression and PTSD is accelerated significantly when they engage in this type of journaling. The journaling and other therapies are not mutually exclusive, but rather work together to enhance the healing process.
The journaling protocol developed by Pennebaker and colleagues is considered spectacular for its important features. It is completely zero cost, requiring only a bit of time and emotional commitment. The intensity of the protocol is noted to enhance its effectiveness. It offers a great degree of flexibility as it can be completed either within four consecutive days or spread across an entire month. More than 200 peer-reviewed studies have shown the protocol to have myriad positive effects on the body and mind, with these benefits being pervasive over not just months, but years.
The initial skepticism about journaling’s impact was overcome upon reviewing the data. The initial studies focused less on the mind and body, with emphasis on immune system and brain neuroscience coming later. The reason this form of journaling is not widely known could be due to it being nested within academic literature. It may also be incorporated into clinical practices.
Next month, a decision has been made to engage in one bout of writing for each week within that month. The choice not to do the four consecutive days of writing was based on personal preference to avoid intense emotional commitment associated with revisiting challenging stressful or traumatic memories day after day for four days.
The protocol involves writing about the same event for all four writing episodes, which can last from 15 to 30 minutes each. Continuous writing is encouraged unless a break is needed due to emotional response. There’s no need for perfect grammar or spelling, but some coherence is useful in case one decides to analyze what was written later. This analysis would involve circling negative words and squaring positive ones, and seeing if there’s an increase in coherence about the topic or event written about.
Each bout of writing should include facts about the events, feelings about those events now and any associations that come to mind about those events. This third category can include anything from past, present or future that is true for the writer. The protocol is intended for the writer’s eyes only unless shared with a dedicated health care or mental health professional. There’s data suggesting that reading about traumatic and stressful events can be traumatic or challenging for the listener.
It’s normal to feel low, depressed, angry or sad immediately after finishing one of these writing sessions, especially for high expressors. It’s important to have a buffer of time after completing the writing before moving into other day’s events. The writing exercise should not be done just before trying to go to sleep at night as it focuses on stressful and traumatic events.
If the protocol is causing significant stress either psychologically or physically, it is recommended to stop. It is also suggested to consider whether one is prepared to deal with the emotional state that might accompany accurate recollection of what happened, what was felt and any links or experiences across the protocol.
The protocol can be used for events that were not the most stressful or traumatic in one’s life as a way of sampling whether it’s suitable. It can provide long lasting positive effects on mental and physical health which makes it too valuable to overlook and not share.