Disclosure of traumas and immune function: Health implications for psychotherapy.

Abstract

Can psychotherapy reduce the incidence of health problems? A general model of psychosomatics assumes that inhibiting or holding back one's thoughts, feelings, and behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences--through writing or talk- ing-is hypothesized to reduce the negative effects of inhibition. Fifty healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for 4 consecutive days. Two measures of cellular immune-system function and health center visits suggested that confronting traumatic experiences was physically beneficial. The implications for psychotherapy as a preventive treatment for health problems are discussed. There is little doubt that psychotherapy reduces subjective distress and yields positive behavioral outcomes. In recent years, a small group of researchers has sought to learn whether psychotherapy can also reduce health problems. Two promising reviews have indicated that the use of mental health services is associated with fewer medical visits, fewer days of hospitaliza- tion, and lower overall medical costs. In a summary of 15 stud- ies published between 1965 and 1980, Mumford, Schlesinger, and Glass (1981) found that individuals who underwent psy- chotherapy evidenced a 13% decrease in medical utilization rel- ative to nonpsychotherapy control subjects. Similarly, in a re- view of 13 studies of mental health services that were intro- duced into organizations, Jones and Vischi (1980) found that psychotherapy was associated with a 20% drop in medical utili- zation.