Article

The Power of Words

Here’s how talking or writing about emotions influences our mental health.

agsandrew/Shutterstock

agsandrew/Shutterstock

There is something therapeutic about putting feelings into words. Many of us feel compelled to shed negative feelings and sort through stressful experiences by talking about them, instinctively seeking out a trusted, receptive listener. Others benefit from journaling about these trials, filling books with cathartic confessions to the self.

In telling our stories, we translate our feelings into descriptive words, an endeavor known as affect labeling. In doing so, the feelings of stress and anxiety are often softened, a phenomenon long recognized and reflected in literature.

Consider what Shakespeare wrote in 1606: “Give sorrow words; the grief that does not speak knits up the o-er wrought heart and bids it break.” Talking about our troubles may be clarifying, provide reality testing, and strengthen interpersonal connection. More important, though, may be the fact that the conversion of feelings to words appears to have a distinct and immediate calming effect on us.

In recent years, the neurocognitive process that accompanies affect labeling has begun to be better understood. What we are learning has provided a degree of clarity as to how talking or writing about stressful feelings provides relief. Perhaps unsurprisingly, we are finding that the relief itself is connected, in large degree, to mindfulness. Words and verbal expression exert a powerful influence over our mental health.

Recognizing and Naming Emotions

Toward the end of the last century, researchers investigating the mind-body connection began designing experiments to test the hypothesis that the expression or repression of feelings can have different consequences for a given individual.1 In the ensuing years, the inability to identify and express emotions—known as alexithymia—rapidly came to be recognized as a transdiagnostic risk factor for mental health disorders.2

Alexithymia has been implicated in a broad range of problems including schizophrenia, personality disorder, major depression, autism, substance abuse, aggression, and self-injurious behavior.3 Research indicates that alexithymia is prominent in numerous forensic populations, including disruptive adolescents, adolescent sexual offenders, perpetrators of cyber-bullying, and adult offenders compared to healthy controls.4 In addition to its connection with aggression, alexithymia is linked to a higher risk of suicide.

The converse appears to be true as well. That is, the better we are at identifying and differentiating emotions, the better we function and the better we feel.5 The ability to identify and articulate negative feelings with some degree of precision attenuates the intensity of the experience. This trait is linked to less engagement in the maladaptive tension-reducing behaviors of nonsuicidal self-injury seen in personality disorders.6 Similarly, evidence indicates that emotion differentiation appears to serve as a protective factor in adolescents and adults.7,8

Research on Neurocognition and Affect Labeling

Affect labeling eases our burden and provides relief, but how does it happen? Focal magnetic imaging technology (fMRI) has provided a previously unavailable means by which to explore the activation and deactivation of the amygdala, the part of the brain known to play a key role in the processing of emotions.

In 2007, a fascinating study utilizing fMRI technology examined the neurocognitive effects of affect labeling on the amygdala and the brain in general.9 Earlier studies had suggested that labeling emotionally evocative images reduces amygdala arousal. This study sought to distinguish whether the linguistic processing of an emotional image results in a greater diminution of amygdala activity than the perceptual processing of the same image.

The experimental design incorporated affect labeling tasks and similar tasks that did not involve affect labeling. Participants were presented with either shapes or faces with expressions and asked to perform 1 of 6 tasks in each block of 10 trials. In the observing task, participants viewed a single emotionally evocative face without making a response. In the affect-labeling task, participants were instructed to choose the correct affect label (“scared,” “angry,” “happy,” “surprised”) from a pair of adjectives shown at the bottom of the screen. The gender-labeling task required participants to select a gender-appropriate name from a pair of names shown at the bottom of the screen.

During the affect-matching task, participants were instructed to choose the face from the pair at the bottom of the screen expressing the same emotion as the target face at the top of the screen. In the gender-matching task, subjects chose the face from the pair at the bottom of the screen that was the same gender as the target face at the top of the screen. The shape-matching task required participants to select a shape from the pair at the bottom of the screen that was the same as the target shape at the top of the screen.

The results were revealing. They indicated that affect labeling, compared to other forms of encoding, diminished the response of the amygdala and other limbic regions to negative emotional images. Affect labeling also produced increased activity in the right ventrolateral prefrontal cortex (RVLPFC). During the task of affect labeling, RVLPFC activity and amygdala activity are inversely correlated, a relationship mediated by activity in the medial prefrontal cortex (MPFC). Their results demonstrated that affect labeling reduces emotional reactivity along a pathway from RVLPFC to MPFC to the amygdala.

Scientists are still speculating as to precisely why affect labeling has a calming effect. It could be that the work of identifying negative emotions operates to detract attention from the experience of negative feelings. This explanation seems unlikely, however, given that gender labeling requires equivalent effort, but does not quell amygdala arousal.9,10 A more intuitively appealing hypothesis is that labeling negative emotions reduces uncertainty, and it is this aspect that imparts a soothing effect.11,12

Significantly, the ability to carefully perceive and distinguish the rich complexity in emotional experiences is a key component of a good many psychotherapeutic interventions.5 Equally important is that self-awareness of emotional experiences is considered a primary feature of dispositional mindfulness.13

Social Media

Most of the research supporting the calming effect of affect labeling has been conducted under experimental laboratory conditions. However, new research utilizing social media has confirmed these findings.

One study tracked the emotional evolution of Twitter users.14 The researchers selected germane tweets by searching for the words “I feel ...” followed by positive or negative emotion words, such as “good,” “bad,” or “sad.” They then conducted a sentiment analysis of all other tweets posted by the user in the 6 hours before and after the seminal one. The findings indicated that following a tweet expressing negative affect, there was a rapid return to an emotional baseline.14

Similarly, a 2020 study analyzed a dataset containing more than 22 million status updates that were voluntarily provided by 153,727 Facebook users, identifying updates that contained words included in their sentiment lexicon.15 The results of the study strongly suggest that affective expression, even by posting a status update on social media, immediately drives arousal and valence toward the baseline by a proportional value.

Mindfulness as an Alexithymia Intervention

Studies have confirmed that mindfulness is correlated with greater emotion differentiation and less emotion lability and emotion dysregulation.16 Research indicates that individuals high in dispositional, or trait, mindfulness have an especially effective and robust response to affect labeling.17 Emotional differentiation is considered a facet of mindfulness.13

The correlation between mindfulness and emotion granularity has encouraged researchers to investigate whether improving mindfulness could have beneficial consequences on granularity in those relatively low in differentiation. Early studies have indeed provided support for the prospect that mindfulness-based interventions can be an appropriate treatment for alexithymia.

For example, a 2019 study utilized the Mindfulness Based Stress Reduction manual protocol to teach mindfulness to participants.18,19 A design that included baseline-, post-, and follow-up with subjects was employed. During each phase, participants reported current emotions and mindfulness skills over a 4-day period.

Results found significant participant improvement in both negative and positive emotion differentiation following training. The findings also suggested that mindfulness mediates the changes in negative emotion differentiation. One study conducted a meta-analysis of 4 available studies on the same subject and concluded that mindfulness-based protocols are appropriate for use in the treatment of alexithymia.20

Concluding Thoughts

These findings offer grounds for optimism. We are born with the desire to put feelings into words, and it seems that talking about these feelings may be an embedded mechanism of self-soothing. As one researcher describes it, “success of the talking cure harkens back to gatherings around ancient campfires.”21

We may be unaware of it as it happens, but when we transform feelings into words, we are implicitly regulating our emotional state and ameliorating discomfort.22 Those who can identify and articulate emotion with greater precision garner superior benefits in the reduction of negative emotions.

Fortunately, we are seeing that emotion granularity is an aspect of emotional expertise that can be honed.23 Precision can be intentionally cultivated through mindfulness-based interventions, using existing protocols. The better we talk about feelings, the better we feel.

Dr Waller is a psychologist with Mindpath Health in Austin, Texas.

References

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2. Preece DA, Mehta A, Becerra R, et al. Why is alexithymia a risk factor for affective disorder symptoms? The role of emotion regulation. J Affect Disord. 2022;296:337-341.

3. Smidt KE, Suvak MK. A brief, but nuanced, review of emotional granularity and emotion differentiation research. Curr Opin Psychol. 2015;3:48-51.

4. Hemming L, Haddock G, Shaw J, Pratt D. Alexithymia and its associations with depression, suicidality, and aggression: an overview of the literature. Front Psychiatry. 2019;10:203.

5. Kashdan TB, Barrett LF, McKnight PE. Unpacking emotion differentiation: transforming unpleasant experience by perceiving distinctions in negativity. Curr Dir Psychol Sci. 2015;24(1):10-16.

6. Dixon-Gordon KL, Chapman AL, Weiss NH, Rosenthal MZ. A preliminary examination of the role of emotion differentiation in the relationship between borderline personality and urges for maladaptive behaviors. J Psychopathol Behav Assess. 2014;36(4):616-625.

7. Nook EC, Flournoy JC, Rodman AM, et al. High emotion differentiation buffers against internalizing symptoms following exposure to stressful life events in adolescence: an intensive longitudinal study. Clin Psychol Sci. 2021;9(4):699-718.

8. Zaki LF, Coifman KG, Rafaeli E, et al. Emotion differentiation as a protective factor against nonsuicidal self-injury in borderline personality disorder. Behav Ther. 2013;44(3):529-540.

9. Lieberman MD, Eisenberger NI, Crockett MJ, et al. Putting feelings into words: affect labeling disrupts amygdala activity in response to affective stimuli. Psychol Sci. 2007;18:421-428.

10. Burklund LJ, Craske MG, Taylor SE, Lieberman MD. Altered emotion regulation capacity in social phobia as a function of comorbidity. Soc Cogn Affect Neurosci. 2015;10(2):199-208.

11. Lindquist KA, Gendron M, Satpute AB. Language and emotion: putting words into feelings and feelings into words. In: Barrett LF, Lewis M, Haviland-Jones JM, eds. Handbook of Emotions. Guilford Press; 2016:579-594.

12. Lindquist KA, Satpute AB, Gendron M. Does language do more than communicate emotion? Curr Dir Psychol Sci. 2015;24(2):99-108.

13. Baer RA, Smith GT, Allen KB. Assessment of mindfulness by self-report: the Kentucky inventory of mindfulness skills. Assessment. 2004;11(3):191-206.

14. Fan R, Varol O, Varamesh A, et al. The minute-scale dynamics of online emotions reveal the effects of affect labeling. Nat Hum Behav. 2019;3(1):92-100.

15. Pellert M, Schweighofer S, Garcia D. The individual dynamics of affective expression on social media. EPJ Data Science. 2020;9(1):1.

16. Hill CLM, Updegraff JA. Mindfulness and its relationship to emotional regulation. Emotion. 2012;12(1):81-90.

17. Creswell JD, Way BM, Eisenberger NI, Lieberman MD. Neural correlates of dispositional mindfulness during affect labeling. Psychosom Med. 2007;69(6):560-565.

18. Van der Gucht K, Dejonckheere E, Erbas Y, et al. An experience sampling study examining the potential impact of a mindfulness-based intervention on emotion differentiation. Emotion. 2019;19(1):123-131.

19. Kabat-Zinn J. Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences. 2003;8(2):73-107.

20. Norman H, Marzano L, Coulson M, Oskis A. Effects of mindfulness-based interventions on alexithymia: a systematic review. Evid Based Ment Health. 2019;22(1):36-43.

21. Cozolino LJ, Santos EN. Why we need therapy—and why it works: a neuroscientific perspective. Smith Coll Stud Soc Work. 2014;84(2-3):157-177.

22. Torre JB, Lieberman MD. Putting feelings into words: affect labeling as implicit emotion regulation. Emotion Review. 2018;10(2):116-124.

23. Wilson-Mendenhall CD, Dunne JD. Cultivating emotional granularity. Front Psychol. 2021 Dec;12:703658.

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