Writing about trauma can affect us profoundly.

A 1986 study found that students asked to write about traumatic memories reduced the number of times they visited a health centre for illness, injury, a check-up, psychiatric or other reasons in six months following the study – but that writing about trauma consistently caused emotional and physical upset immediately afterwards.

Such unpleasant after-effects are now widely accepted as part of the healing process enacted through written emotional disclosure.

Amid a global pandemic, our moral distress persists, despite the success of virtual health-care systems. Writing can be a companion to a chaotic mind in ways that do not involve revisiting trauma.

Here are three evidence-based therapeutic applications of writing and three accompanying prompts.

Use writing to ground

Therapists advise a method known as grounding for people suffering from distressing thoughts. Grounding entails taking note of physical surroundings to calm the triggered body by rooting it in the present. The “5-4-3-2-1” technique asks you to note five things you can see, four you can hear, three you can feel, two you can smell and one you can taste.

The technique parallels a writing prompt for “re-embodiment” in the present, from poet and psychotherapist Ronna Bloom. Following the advice of Bloom and trauma therapists, use simple, focused writing to take poetic hold of the present by writing about an object from your immediate surroundings.

Prompt: Find something nearby that excites your senses, like a fruit from your kitchen. Take the object in your hands. Smell it. Rub it against your cheek. Beginning with “I hold” or “I smell,” or any words you like, write for eight minutes on what you have chosen.

Use writing to find ‘flow’

What does it mean to “live your best life”? Psychologist of optimal experience Mihaly Csikszentmihalyi studied where people were, and what they were doing, when they were living their best lives. Subjects reported living optimally while engaged in a fluid, creative state Csikszentmihalyi called “flow.”

Characterized by the ordering of thoughts in service of fluid creation, flow tends to result in an enjoyably focused, resilient state known as “psychic negentropy.” Csikszentmihalyi found those who experienced psychic negentropy regularly, including creative writers, tended to be happier people.

Prompt: For entry into flow, it is wise to select a prompt that promotes guided expansion. The ideal is to increase ease with which we enter flow and decrease distractions that make flow harder to maintain. One way to do this is to revisit a personal memory. Choose something mundane yet fresh, something you do often, with many vivid details that will keep your hand moving and thoughts engaged in the telling. Write until you feel finished.

Use writing as a safe play space

Psychoanalyst Donald Winnicott stressed that play was crucial for child development. Developmental play occurs in a safe, bounded space. In play, children manipulate what Winnicott called “transitional objects” (usually toys, bottles or blankets).

As Winnicott noted, the space for developmental play opens for adults, too, where there is need of healing, often by way of artistic practice. For adults requiring self-understanding, transitional objects can be pen and paper, where writing is the location of bounded, safe, developmental play.

Prompt: Consider a playground for very young children with their caregivers, perhaps with a swing set and slide, within an open, grassy park. Though boundaries like a simple wooden fence surrounding the young children’s playground constitute limitations, these limitations are there to support their safety. In this bounded play space, a child explores, while their caregiver, at a slight distance, is engaged in what Winnicott described as the crucial caring act of creating a “holding” environment, or holding space, for a child — attending to and being present for them, while allowing their expression and exploration.

We can put boundaries in place for ourselves as we write, while attending to our emerging and vulnerable feelings, to ensure emotional safety in the space for developmental play.

Writing with compassionate limitation can be therapeutic and allow expansion in other directions. This means deliberately choosing to direct our focus, topics and energies.

For example, professor of psychology Laura King asked subjects to write about their “best possible future selves” and found these writers showed the same health improvement at six months as people who had written about their traumas did, minus the upset afterwards.

King prompted subjects as follows: “Think about your life in the future. Imagine that everything has gone as well as it possibly could. You have worked hard and succeeded at accomplishing all of your life goals. Think of this as the realization of all your life dreams. Now, write about what you imagined.” As King’s subjects did, write for 20 minutes per day over four consecutive days.

If none of the above engages you, write freely and intentionally, keeping in mind that an empowering writing experience will avoid rumination, sustain engagement and leave you with a sense you have spent time meaningfully. Writing-based wellness must meet you at your own points of interest and excitement. Writing that heals is writing that comes forth easily. Consider what topic renders writing therapeutic, for you.

Elizabeth Bolton Cartsonas is Assistant researcher, Literacy Education, Department of Curriculum, Teaching, and Learning, Ontario Institute for Studies in Education, University of Toronto.

This article first appeared in The Conversation.