[2023-01-31] Writing through cancer

Ovarian Cancer Canada hosted a webinar this evening on the topic of Writing through cancer: How writing can help us heal. The event was led by Dr. Sharon Bray, author, educator and, herself, a cancer survivor.

Sharon has extensive experience helping patients through the therapeutic use of expressive writing, beginning with cancer patients in 2000, and expanding to cardiac patients and transplant patients in more recent years.

What is expressive writing? Quoting researcher and author James Pennebaker, Sharon said:

"It is writing about thoughts and feelings related to stressful or traumatic life experiences without concern for style, spelling, punctuation or grammar."

The end of Pennebaker's quote is crucial. Expressive writing is not creative writing or writing that is honed and polished for an external audience. It is writing that focuses on the stressful or traumatic experience without worrying about how the writing sounds or how someone else might judge it.

Sharon spent a few minutes describing the benefits of expressive writing (improved quality of life, improved immune system functioning, better quality of sleep, improved mental and physical health) and explained how expressive writing heals (by helping the writer to translate feelings into words, to gain greater self-understanding and insight, and to reclaim their voice) but she devoted the bulk of the hour to leading a two-part expressive writing exercise. First, she invited participants to write about the moment they first heard the words "you have cancer." She gave us five minutes (she would later explain the importance of setting a timer for expressive writing) to write quickly and freely. Do not stop to re-read or edit, she said. Keep your pen or fingers moving. When the five minutes had ended, she asked us to read over what we had written and to note any surprises.

This was an interesting exercise. I've written and recounted the story many times of hearing the words "you have ovarian cancer"—sitting in a small room in the Emergency Department with the ER doctor. What was interesting, however, was a memory that came up tonight that I hadn't recalled previously: "After I had sat down," I wrote tonight, "the doctor asked me whether I had anyone there with me. I said no." That was my first inkling that something was seriously wrong, that what he had to tell me would be difficult for me to receive.

Sharon invited participants to share what they had written. Those who spoke told touching stories that reflected real emotions. Sharon asked how we had felt writing under time pressure. I found the time pressure freeing, or at least the rules around not editing or re-reading during the five minutes. My focus was on letting the story unfold.

Sharon then asked us to write again, this time choosing from one of a list of writing prompts:
  • When the doctor said "cancer"
  • What keeps me awake at night
  • What I would change if I could
  • Today I feel like...
  • Something that makes me angry
  • What gives me hope
  • How I feel about my changed body
  • A letter to cancer
  • What I fear
  • What I am grateful for
  • How I would like to be remembered
The final question immediately resonated with me. For the next five minutes, I poured out a list of 18 things I wanted to be remembered for, among them:
  • Someone who wanted to make others' lives better
  • A kind and loving person
  • A wonderful mom
  • A devoted wife
  • An exceptional leader
  • Someone who never stopped learning
  • A light in the world
  • Someone who took everything cancer brought and turned it into something that made her and those around her better
When I wrote the line about being remembered as a wonderful mom, I almost choked up. But I kept on writing.

Sharon noted that when we have suffered, we can become more compassionate and aware of other people's suffering. Our pain can make us more caring and understanding of others.

Sharon's guidance for writing to heal was this:
  • Have a quiet place to write where you will not be interrupted.
  • Set a timer for 15 minutes and write without stopping.
  • When the timer goes off, stop.
  • Read and reflect on what you wrote, highlighting sentences or phrases that stood out for you.
  • The next day, write again, starting with one of the phrases you had highlighted the day before—once again, setting a timer.
  • Write for 3-4 days in this way.
This is what writing for healing is like, she explained.

Sharon did share one cautionary tale in relation to expressive writing, drawing from both research and her own lived experience. After going through a personal tragedy, Sharon turned to writing. It made her feel better for a time, until she started repeating herself, and then she didn't feel better. When we write without time limits, she said, we can easily go down the rabbit hole and slip into rumination. "If writing makes you feel worse," she advised, "stop writing and find someone to talk to."

The hour with Sharon was so much more than I had expected. I had anticipated a speech, but was delighted to participate in a mini-workshop that allowed me to learn (or, at least, be introduced to) expressive writing, and to practise using the tools. Towards the end of the session, Sharon noted that she includes writing prompts on her website WritingThroughCancer.ca. She also recommended Kathleen Adams' book The Way of the Journal: A Journal Therapy Workbook for Healing.

I recall an oncologist telling me very early in my cancer journey about the benefits to cancer patients of journaling. 900+ days later, I would echo what Louise DeSalvo wrote in Writing as a Way of Healing (which is how Sharon started her presentation): "Writing has helped me heal."