From the beginning of recorded history, people in diverse cultures have embraced the idea that creative expression, including visual art, stories, dance and music, contributes to healing.
In recent times the therapeutic benefit of expressive writing has been well researched in the global north, but not in the global south. This is a significant gap because potentially healing interventions need to be investigated in different contexts, particularly where trauma, limited resources and a need to build a caring and compassionate society exist.
A recently published paper analysed the findings of a study among a diverse group of South Africans who were members of a writing group, the Life Righting Collective. Medical students at the University of Cape Town interviewed 20 members of the collective as part of a medical humanities study module.
We were co-authors of the paper. The research team included medical practitioners, medical students and academics with interests in mental health and medical humanities. Two authors also facilitate Life Righting Collective life writing courses.
Most participants reported improvements in overall wellness and mental health as a result of these writing courses, in line with other research findings which show that creative writing can promote healthier choices as well as improve relationships, mental health and work prospects.
The research findings indicate that the courses can be a useful, non-medical, cost-efficient method to improve psychological well-being.
How it works
The Life Righting Collective promotes creativity as an innate resource for processing one’s experiences. Writing courses of different lengths accommodate between eight and 18 people. The organisation raises funds to sponsor those who cannot afford the courses, thus ensuring inclusivity and diversity. The aim of the writing courses is to promote creativity and play as learning tools for change, whereby negative and stuck narratives can shift into stories that support, create connections, empathise and encourage.
A facilitator who is experienced in group process, personal psychology and the neuroscience of creativity oversees the writing exercises and feedback sessions. They create a safe space through confidentiality, supporting personal agency and respectful listening. They encourage participants to grow and value their own individual creative expression, and to follow their intuition about what to write and what to share. The writing exercises allow for new approaches to narrate what happened.
Before participants read their work aloud, content warnings are discussed.
When both those reading their work and those listening discover that others have encountered similar life challenges, it can create a sense of community. The facilitator is trained to be on the alert for divisive comments or language, and to bring this to the group’s attention with sensitivity.
The facilitator emphasises that the course is not a therapy group, but that regular writing practice is good for well-being. If participants become distressed, the facilitator helps them process this outside the room, one on one, while the rest of the group writes.
Participants are given a mental health resource list should they need additional support.
The experience
Some participants reported an improvement in their writing capabilities as well as life skills and personal development. As one participant put it:
She taught one how to focus what you are trying to say, how to make it more readable, simpler. Just generally how to do it more effectively, artistically but also keeping it very authentic.
Another said:
Through my writing my English improved … No one could believe it was me, even when I read the reports I wrote … It gave me life skills and it even changed my situation financially, because now I can enter competitions, I can write reports and get paid whatever little money, which means I can also earn a living.
Participants noted that writing about challenging life circumstances led to increased understanding of self and others. One said:
You attentively listen to someone’s story so that you’re able to give them feedback … you can use those tools outside of the group because we all have to sit in meetings, social or academic groups and we need not to be triggered or offended by someone and still be able to give constructive feedback, that is a skill that a lot of people do not have.
The view of another:
Once you’ve shared your stories, there is a kind of a bond that is very special.
Some participants noted improved self-confidence and feeling empowered.
The course really gave me the courage to even to finish up something I’ve been working on before that course. Now I can look at myself very kindly because one of the things I struggled with is that I am too hard on myself.
The writing process had a spiritual dimension for one participant.
Your spirit gathers things in life differently than your mind does. And your spirit already has some answers for you and you can write them up.
Some mentioned managing health-related challenges better as a result of the course, including depression, anxiety and grief, as well as some physical conditions.
Participants also gave examples of how the course helped them express their experiences of trauma, such as family issues, rape, living under apartheid and war.
I grew up in the days of apartheid, so there was always a pain in me …
Another comment on the same topic:
My family did not help me find counselling … when I experienced flashbacks and nightmares because of the war {in the DRC} … no-one could understand, and they were only thankful that I was alive.
And another:
We lost our oldest son to cancer … I then started writing a journal, which I called my grief journal … working with your emotions towards healing from grief.
One participant said:
There were new voices inside of me … it really has affected my whole way of seeing myself and the melancholy – it helps lift it.
The future
We concluded that shared writing in group settings is invaluable to promote care of self and others, both in more homogeneous and in diverse communities. The experiences of course attendees suggests that bearing witness to societal circumstances that need recognition and attention, and communicating one’s life experience through life writing, can promote confidence and advocacy.
These benefits are particularly important for resource-constrained countries like South Africa with historical and ongoing multiple traumas that need low-cost and replicable interventions to assist people recover a sense of well-being, self-worth, agency and community. Facilitation skills can be acquired by non-professionals, thereby increasing access to care in individuals and communities where there is literacy in any language.
We argue that benefits could be disseminated through incorporating similar courses in education and training curricula in schools, tertiary education institutions, government departments, non-profit organisations and other community-based groups.