Research shows that putting pen to paper can help patients overcome depression. Some doctors even think it eases physical illness like arthritis. By HESTER LACEY
Alice Walker, Isabel Allende, Henry Miller, Djuna Barnes, Janet Frame and Jamaica Kincaid are all authors who have testified to the therapeutic power of writing. All have noted that their work helped them to overcome or come to terms with traumas and difficulties in their lives; that putting their thoughts and feelings down on paper was an effective way of dealing with them. According to Louise DeSalvo, author of Writing as a Way of Healing, it is not just famous or even published writers who can benefit from the cathartic power of the written word.

DeSalvo, who teaches creative writing at Hunter College in New York, insists that setting difficult experiences down on paper is an effective way of analysing and coming to terms with them. "We receive a shock or a blow or experience a trauma in our lives," she says. "In exploring it, examining it and putting it into words, we stop seeing it as a random, unexplained event. We begin to understand the order behind experiences. Expressing it in language robs the event of its power to hurt us. It also assuages our pain."

She points also to recent research in the US that shows writing is beneficial not only mentally but also physically. "People in the act of writing have been studied physiologically and there is a quieting of the body, a slowing of the pulse and a calming of the breathing." And, she notes, patients with chronic illnesses such as asthma and arthritis have also found relief through writing. A study written up in the Journal of the American Medical Association has found that sufferers who wrote about their problems improved twice as quickly as other patients; the report suggested it is "possible that the writing task changed the way people thought and remembered previous stressful events in their lives and helped them cope with new events".

To benefit, says Louise DeSalvo, it is not necessary to be an experienced or a skilled writer. "The therapeutic uses of writing do not depend on excellence, simply on expression," she explains. "You can write ungrammatically, you don't have to worry about spelling." Don't, she says, be put off by the notion that writing is somehow a "gift" and either you can do it or you can't. "Every great writer was once a beginning writer," she points out. "Look at the really early works of established writers. If you were beginning to learn the piano you wouldn't expect to start with Chopin - it simply doesn't work that way. Just like music, writing is an acquired skill."

Nevertheless, she says, a modicum of discipline is required. She recommends setting aside a certain amount of time on a regular basis. "Set a schedule, as one would for any healing art like meditation or yoga. It can be 10 minutes every other day, or 20 minutes a day - but make a promise to yourself and keep it." Therapeutic effects lasting several months have been recorded in asthma and arthritis patients after stints of writing that have lasted for as little as 20 minutes per day over three days, though more is preferable. "Anyone can find 20 minutes on three consecutive days to help themselves, though there is something to be said for sustained practice," says DeSalvo. "If you can get such good results from so little, imagine what you can achieve with doing more!"

Another important principle, she says, is not to censor what you write. "People immediately think 'This is stupid' or 'I shouldn't think this' but the first thing is to get free on the page." And don't, she says, fall into the trap of writing a long essay full of self-pity. "What you record shouldn't be a litany of moans about a dreadful day. You describe what you feel and take a step back: you try to achieve some wisdom about it," she explains. "You don't get stuck in a rut of feeling sorry for yourself, or going over and over things; you get some perspective."

Just a pen and pencil are all the materials needed, though, says Louise DeSalvo, some people prefer to write in a beautiful blank book with a special pen. If a word processor or computer is used, it is important to print out what is written. "This is also about making a physical object, creating something tangible," says DeSalvo. "I keep a journal and for me it's a remarkable artefact, a history of who I've been."

Writing, she says, is not a "magic bullet" that can help everyone, but those who do find it works may be surprised by the cathartic results. It is not, however, something to be undertaken lightly, she warns. "I always tell people who undertake this seriously and anticipate dealing with serious issues to make sure they have a support system in place, anything from an important confidant to Alcoholics Anonymous or any of the healing groups, or a therapist. You may begin to have feelings you haven't felt before." Initially, she says, this release of feelings may be painful. "This is not supposed to make you feel 'better', it is supposed to make you feel appropriate, and if, for example, you have suffered a loss you haven't mourned, then mourning will be the appropriate feeling. I've found that writing is an especially good technique for people dealing with grief and loss, and if you have a human life you will have experienced these."

In this country, too, the idea of writing as therapy is gaining ground. The use of creative writing as therapy for adults has featured in the British Medical Journal. Larry Butler is involved with two writing groups, the Association for the Literary Arts in Personal Development (Lapidus), which promotes awareness and understanding of the links between writing and personal development, and Survivors' Poetry, a network of writing groups throughout the UK particularly aimed at people who have been through experiences such as counselling, therapy or ECT. He has recently been awarded a grant by the New Opportunities Millennium Board to develop a creative writing programme in Glasgow to which GPs can refer patients suffering from anxiety and depression. "Writing is like thinking on paper," he says. "If you have feelings of anxiety, you can write about them and achieve clarity. Or you can use creative writing for planning a major change in your life, getting all the issues down on paper."

Through the Neal's Yard Agency for Personal Development, it is possible to book shorter courses. The Ashburton Centre in Devon has chosen creative writing as the theme for its autumn programme, and the long weekends will be led by recognised authors. Courses run by established writers are also available via Neal's Yard on the Greek island of Skyros, and the Skyros Organisation also offers fortnights in Thailand to which participants are invited to bring "their obsessions, childhood memories, and a sense of humour".

"Once you are writing you can reflect, distance yourself, gain a new overview," says Neal's Yard's Ulrike Speyer. "Many people start with journals or writing down their dreams. Working with a group can be very exciting, especially with an author present. Participants will get inspired and be encouraged to follow their instincts."

Initially, says Louise DeSalvo, many people will prefer to write for their own eyes only. But, she says, progress is ultimately achieved more quickly in a group. "There is a great synergy in groups. And you are not just helping yourself, you are helping others. Also, isolation is one of the curses of our times, and doing anything to break that down is positive." And for beginners it can be very encouraging to see that others are inspired or interested by their work. DeSalvo herself has been writing herself since 1975. She says now: "Writing has helped me heal. Writing has changed my life. Writing has saved my life."

'Writing as a Way of Healing' by Louise DeSalvo is published by The Women's Press 9 September, price pounds 8.99. Contact Survivors' Poetry on 0171 916 5317, Lapidus at BM Lapidus, London WC1N 3XX. Neal's Yard Agency for Personal Development 07000 783704 or