Writing about health as therapy and a commitment device

Writing about health can be a kind of therapy, a means of turning a bad break into something with a more positive (if not altogether happy) ending.

WRITING ABOUT one’s health publicly can have a similar effect. (photo credit: PIXABAY)
WRITING ABOUT one’s health publicly can have a similar effect.
(photo credit: PIXABAY)
When I was first diagnosed with follicular lymphoma three years ago this month, it was clear I was going to write about it – that’s just what I do. What I didn’t realize was how documenting my journey publicly would change me and, in particular, my commitment to honesty with friends, family and readers.
Writing about health challenges is nothing new – witness the growing number of websites, articles and book-length memoirs of people who are either suffering from an illness or have beaten it into remission, even if just temporarily.
More recently, the number of articles appearing online about COVID-19 – ranging from heartbreaking health challenges to practical steps for coping pre- and post-lockdown – have multiplied even more rapidly.
There are many more medical stories that take place farther from the limelight. In the last 20 plus years, for example, over 850,000 people have created a health journal through the website CaringBridge, which claims that one in eight people in the United States visited the site in 2019.
WRITING ABOUT health can be a kind of therapy, a means of turning a bad break into something with a more positive (if not altogether happy) ending.
I’ve been doing this for years – and not just with illness.
When my wife, Jody, and I got caught outdoors in a sudden downpour on a hike in Norway, I connected that experience with ACT, an analytical technique that blends mindfulness with cognitive behavioral therapy, as a way of flipping the script on our extreme dampness.
Crafting such a column forces the writer to conceptualize an event as a story with a beginning, middle and end, maybe an uplifting moral. After a while, the writer may even come to believe the ending he or she has written for this “fictionalized” version of the story.
In this way, writing publicly about health challenges becomes a version of what behavioral economists call a “commitment device.”
Freakonomics author and podcast host Stephen Dubner describes a commitment device as “a clever means to help you commit to a course of action that you know will be hard. That might mean losing weight, quitting smoking or anything else involving willpower.”

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Imagine two versions of yourself, Dubner proposes: current you and future you. If you know that your future self will want to follow a behavior that your current self is not comfortable with, you can “make a deal to punish (or reward) yourself if the future self doesn’t follow through on the current self’s promise.”
Odysseus essentially did that when he had himself “lashed to the mast of his ship so he couldn’t succumb to the song of the Sirens,” Dubner explains.
Buying a gym membership (and committing to posting a selfie a day) to force yourself to get in shape is another example.
There are even websites like Stickk.com, where users join a public community (say, “Diet and Exercise”), state their goal (“lose 10 pounds [4.5 kg.] in a month”), put down some money ($200 is a good starting point) and define what will happen to the money if they don’t stick to their commitment. Stickk says that adding financial stakes triples one’s chances of success, and that its users have put “$50 million on the line.”
Dubner describes the case of Adam Scott who wanted to reduce his unhealthy habits – everything from drinking too much to watching excessive TV. If he failed, he declared on YouTube, he would send a $750 check to someone “whom he really, really didn’t want to give his money to: Oprah Winfrey.”
Now, you might be a fan of Oprah, but you get the point. By going public with his commitment, Scott was signaling that he would do whatever it took to carry through with his pledge.
Writing about one’s health publicly can have a similar effect. When I end a story with a positive, that helps shape my attitude – even if it’s just for the hour I’m writing down the words. When I know that thousands of people are reading that affirmation, it creates a feedback loop: I’ve put it out there; now I’m being held accountable.
What if I don’t feel so positive by the time the article is published? Embedded in this public contract is a commitment to honesty. If my health deteriorates, I will tell you about that, too.
At the same time, I can also access the happy ending that I wrote previously to remind myself that, however lousy I may feel at the moment, there was a time not so long before when things were different – and it’s likely that things will change again soon.
That’s certainly a message we could all stand to hear with COVID-19 still raging around us.
One more benefit: Sharing your story publicly when you’re having a good day can help mitigate the propensity to feel sorry for yourself on the bad ones.
While commitment devices can be effective tools for keeping yourself on a productive path, and are particularly relevant on days like today, January 1 – New Year’s Day, when making resolutions is a time-honored tradition – they’re not foolproof. Adam Scott wound up mailing that check to Oprah for a relatively minor infraction – he pledged to cut out milk from his diet, then accidentally put a couple of small containers of 2% cream in his coffee.
Still, should you find yourself in a health crisis feeling understandably down, consider writing – publicly, privately, on CaringBridge, Stickk or another support site. Think about your pain as part of a bigger story and, if you’re feeling up to it, craft an ending that gives you hope.
The writer’s book, Totaled: The Billion-Dollar Crash of the Startup that Took on Big Auto, Big Oil and the World, is available on Amazon and other online booksellers. brianblum.com