Cognitive Behavioral Therapy: Using Storytelling to Decrease Depression and PTSD Symptoms

Monday, July 14, 2014 by Meg   •   Filed under Treatment Techniques

Sometimes a pencil is just a pencil. (I think Freud said that.) And sometimes, a pencil is a great deal more. (He probably said that too.)

Writing is a powerful tool for those dealing with mental health issues. It might be especially important in cases of trauma where integrating memory is a critical part of healing. Creative engagement, in the form of writing or other artistic expression, serves to decrease anxiety, stress and other psychological disturbances1


As if you needed more excuses to lock yourself up with a notebook, expressive writing also improves complications of Post-traumatic Stress Disorder and depressive symptoms in those with a history of sexual abuse2. Writing may also improve sexual dysfunction issues in those who write specifically about sexual topics2. This type of writing may also serve to decrease depressive symptoms in those from abusive relationships3.

That's a pretty powerful pencil.

Even studies that did not find decreases in PTSD symptoms following writing exercises still reported that those who engaged in writing were better able to handle scary physical stress responses, and that dysphoric mood--feeling generally unwell or dissatisfied--decreased4

But be patient. Because women who write about their traumatic experiences may feel worse initially, though they fare significantly better over time5. This is because writing may serve to assist in integrating memories as well as processing the information in other ways, which may temporarily increase anxiety and PTSD symptoms as the body tries to deal with this influx of information. Difficult in the short term, but usually necessary for healing in the long term.

While expressive writing in general clearly has merit as a way to improve emotional issues and speed recovery, there may be a specific writing technique that is particularly beneficial in combating the loss of control often felt in cases of trauma.

Using Creative Writing To Combat Trauma and Other Scary Memories 

Re-imagining a trauma with a different ending can be beneficial according to Dr. David Burns, author of When Panic Attacks6, and Dr. Peter Levine, author of Waking the Tiger: Healing Trauma7. This particular technique usually combines elements of flooding (or exposure therapy) with storytelling which reframes the event with the victim in a position of power. 

A.K.A. The "imagine yourself beating that fucker down" technique.

While this technique can be done internally through visualization or vocally with a therapist, being able to write about the event tends to be more beneficial in the long term, for both comfort reasons and individual empowerment.

Power to the people. You have more control than you think. However, the writing can be shared with your therapist at a later date as a way to cement the process if you choose. 

Here's how you do it:

  1. Remember the trauma, in detail, from the beginning, a type of cognitive exposure technique.
  2. At some point in the story, begin to rewrite the script, changing it into something more palatable. 

Simple, and yet often quite difficult. 

For rape victims, this may mean remembering the initial struggle, but changing the ending so that they injure their attacker. For someone with recurring dreams about a dog attack, remembering the initial chase and the first bite, but rewriting the end so that they punt that drooling bastard over the fence may help to quell the anxiety response. A victim of molestation may imagine the events and end with yelling at the perpetrator or getting them to stop by other means.  

Often these visualizations get brutal and bloody, with imaginings no where near as tame as dog-punting. That's normal, and completely okay. Feeding an abuser to a wood chipper isn't reality, nor will it become reality. But, for some, it's comforting to picture.

“Sayonara, mother fucker.” 

While these techniques will not change the reality, even in the minds of the storytellers, rewriting past events in this way may help victims of trauma to feel more powerful and confident, thus allowing them to cope more effectively with the trauma itself. 

Power and control are not things we give up lightly. Storytelling may be an initial step towards recovering them.


Related Posts:


Topic-Relevant Resources

The Mindfulness Solution
Meditative and cognitive techniques for everyday use

When Panic Attacks
Detailed overview of cognitive behavioral techniques for changing negative thought patterns

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms
A useful tool in exploring personal trauma, with an emphasis on healing.

Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy
Self help techniques using Eye Movement Desensitization and Reprocessing (EMDR) a therapy especially helpful in trauma and anxiety cases.

Mindsight: The New Science of Personal Transformation
New techniques for mindfully altering the wiring of your own brain, leading to increased happiness.