While some earlier literature can be described as confessional, confessional writing as a distinct style and genre emerged in America following World War II. This style became especially prominent in poetry, most notably in the work of Adrienne Rich, Robert Lowell, and Sylvia Plath.

The form became connected with Postmodernism in the 1960s, sharing such features as self-performativity, self-reflexivity, a rejection of strict meter and form, and fusions of personal conflict and historical trauma. Both literary genres emerged as a response to collective traumas such as World War II, the Holocaust, and the Cold War, as writers sought to externalize internal anxieties. By the end of the 20th century, the style had also taken on elements of Postcolonial theory, with writers from marginalized communities using the confessional form to describe the experience of the colonized, and issues surrounding oppression, history, race, and gender.

Confessional writing typically uses first-person narration in non-fictional forms, such as memoirs and diaries, to describe personal revelations. The genre’s language is often colloquial and direct, allowing authors to radically reduce the distance between their writerly personas and their real selves.