I have kept journals over the years. At times, I called them My Management Journal, then later, My Daily Record of Events. My inspiration was no less than good old Benjamin Franklin who maintained what he called his Virtues: Daily Record and Journal. Suffice to say that journaling has been a big part of my life since I first started my careers (first in business as a manager, then later as a mental health professional).
I first used them to record both hits and misses as a businessperson, with the objective of learning (mostly from my mistakes and bad decisions). Later I would use them to write out my goals and plans to achieve them. I’ve evolved to using journaling as an avenue to become more self-aware.
By this process, progress in life takes on a certain kind of animation and allows you to “look back” on where you’ve been. You can discern trends and themes, both of which can help you to adjust course going forward. This helps lock in the necessary identity shifts for long-term change and it acts to navigate the eventual obstacles that pop up.
That’s why today I want to share an evidence-based journaling practice that’s been shown to improve life along several dimensions, including lung function in asthma patients, immune responsiveness, pain alleviation, and sleep improvement.
The great thing about it is that it’s zero cost. An even better aspect is that it could change your life.
Therapeutic Journaling is what I recommend to my life coaching clients. Years ago, it was recommended to me and was beyond useful in helping me to make it through the chaos we call like. Created by renowned scientist Dr. James Pennebaker, therapeutic journaling involves these steps:
- You pick an emotionally triggering event in your life. This could be positive or negative, so be sure to give equal weight to both.
- Then sit down and write down every thought about that event for 15-20 minutes. Use a pen or type this on digital. The key is to not stop to think. Just keep writing.
- Write for yourself. No one will see this.
- Do this for either 4 days straight or once a week for 4 weeks. The results will be the same.
- If an event is still too upsetting to write about then don’t write about it until your emotions have died down. In the meantime, pick another event to write about.
- After you’re done with this process look at what you’ve written.
When traumatic events occur, we are often not able to process what happened and the event can become stuck in our memory. This type of journaling works because emotional expression is good for our health and can enhance our immune system. By expressing our thoughts on paper, we can move forward by letting go of the feelings involved.
Recently, the University of Wisconsin (another “UW” but not the one I am affiliated with, that one being the University of Wyoming) published an article on the process, which I am happy to share with you now.
What Is Therapeutic Journaling?
Therapeutic journaling is the process of writing down our thoughts and feelings about our personal experiences. This kind of private reflection allows us to sort through events that have occurred and problems that we may be struggling with. It allows us to come to a deeper understanding about ourselves, with a different perspective on these difficulties.
Therapeutic journaling differs from more traditional diary writing, which involves recording the details of daily events. In contrast, therapeutic journaling is an internal process of using the written word to express the full range of emotions, reactions and perceptions we have related to difficult, upsetting, or traumatic life events. Along the way, this can mean writing ourselves to better emotional and physical health and a greater sense of well-being.
Therapeutic journaling can be done by keeping a regular journal to write about events that bring up anger, grief, anxiety, or joy that occur in daily life. It can also be used more therapeutically to deal with specific upsetting, stressful, or traumatic life events.
An expressive writing protocol developed by Dr. James Pennebaker is the most widely used and researched method utilized in clinical practice. This writing protocol has been linked to improvements in both physical and psychological health. It has been used in non-clinical and clinical populations.
The expressive writing protocol consists of asking someone to write about a stressful, traumatic or emotional experience for three to five sessions, over four consecutive days, for 15-20 minutes per session. Research has found it to be useful as a stand-alone tool or as an adjunct to traditional psychotherapies.
How It Works
Emotional expression has been found to be good for our health. It enhances our immune system functioning. When upsetting or traumatic events occur, we often are not able to fully process what happened, and the event and the emotions around what occurred become stuck in our memory. The simple act of expressing thoughts and feelings on paper about challenging and upsetting events can allow us to move forward by expressing and letting go of the feelings involved.
Expressive writing also provides an opportunity to construct a meaningful personal narrative about what happened. It brings clarity and enables us to place our experience into the context of our larger place in the world.
Over the past 25 years, a growing body of research has demonstrated the beneficial effects that writing about traumatic or stressful events has on physical and emotional health. Dr. Pennebaker, one of the first researchers in this area, found that writing about emotionally difficult events or feelings for just 20 minutes at a time over four consecutive days was associated with both short-term increases in physiological arousal and long-term decreases in integrative health problems, such as immune system functioning.
One study, a meta-analysis of 13 studies of written emotional expression with healthy participants, found specific benefits in objective or self-reported physical health, psychological well-being, physiological functioning, and general functioning outcomes.
In another meta-analysis of nine studies on written emotional disclosure on clinical populations and found significant benefit for health outcomes in medically ill populations but did not find any psychological health outcomes in psychiatric populations.
Expressive writing has been found to produce significant benefits for individuals with a variety of medical conditions including:
- Lung functioning in asthma
- Disease severity in rheumatoid arthritis
- Pain and physical health in cancer
- Immune response in HIV infection
- Hospitalizations for cystic fibrosis
- Pain intensity in women with chronic pelvic pain
- Sleep-onset latency in poor sleepers.
- Post-operative course
In addition, it can be helpful for assistance with specific life circumstances, including:
- Relationship break-ups
- Death of a loved one
- Unemployment
- Natural disaster
- General stressful events (aka, life in general)
In 2012, researchers conducted a meta-analysis investigating the efficacy of expressive writing for treatment of posttraumatic stress conditions (e.g. acute stress disorder and PTSD) and comorbid depressive symptoms. It resulted in significant and substantial short-term reductions in posttraumatic stress and depressive symptoms. There was no difference in efficacy between writing therapy and trauma-focused cognitive behavioral therapy. The effects of written emotional expression are substantial and similar in magnitude to the effects of other psychological interventions, many of which can be time consuming and expensive. Expressive writing can therefore be considered an evidence-based treatment for posttraumatic stress and constitutes a useful treatment alternative for patients who do not respond to other evidence-based therapies. It may be especially useful for reaching trauma survivors in need of evidence-based mental health care who live in remote areas.
Therapeutic journaling can also be a way to reach people who are unwilling or unable to engage in psychotherapy.
Therapeutic Journaling Instructions
This writing exercise is useful for dealing with emotional upheavals or traumas. It is a four-day writing program that has proven effective for improving mental and physical health. It is best to do your writing in a meaningful place, time, and atmosphere, so think about finding a location where you will be undisturbed by others, your phone, e-mail, etc.
It is important to think about what your writing topic will be. You might pick an emotionally upsetting event that is bothering you. If you have faced a massive trauma, it is best not to write about it for several weeks afterwards, as it may be too difficult to deal with some of the emotions that arise around what happened.
Trust where your writing takes you. You might start writing about a traumatic experience and then find yourself writing about something entirely different.
For the next four days, please write about an emotionally upsetting or traumatic event that has had a strong impact on you. During your writing, you are encouraged to explore your deepest emotions and thoughts about this difficult life experience. As you write about this topic, you might tie it to your relationships with others. You may relate it to your past, present, or future, or you may connect it with who you may have been, who you would like to be, or who you are now.
You may write about the same general issues or experiences on all days of writing, or you may choose to write about different topics each day.
Keep in mind these few simple guidelines recommended by Pennebaker:
- Writing topic. You can write about the same event all four days or different events each day. What you choose to write about should be something that is extremely personal and important for you.
- Length and frequency. Write for 15-20 minutes each day for four consecutive days if you can. It is a bit more effective than writing four days over the course of several weeks.
- Write continuously. Once you begin writing, write continuously without stopping. Don’t worry about spelling or grammar. If you run out of things to say, simply repeat what you have already written. Keep writing about the topic until the time is up.
- Write only for yourself. You are writing for yourself and no one else. After you complete the expressive writing exercise, you may want to destroy or hide what you have written. Remember this writing can be for your eyes only.
- What to avoid. If you feel that you cannot write about a particular event because it would be too upsetting, then don’t write about it. Just write about events or situations that you can handle now.
- What to expect. It is common for people to feel somewhat saddened or depressed after writing, especially on the first day or two. Know that this is completely normal, if this happens to you. Typically, the feeling usually lasts just a few minutes or a few hours. It is a good idea to plan some time to yourself after your writing session to reflect on the issues you have been writing about and support yourself in any emotions that come up.
- Considerations. Writing about the same topic day after day for too many days is not helpful. If, after several sessions, you feel you are not making progress, then you might need to stop and contact a health care practitioner.
- When to discontinue the journaling exercise. Writing exercises aren’t for everyone. If the writing exercise evokes strong feelings that you cannot cope with, stop immediately and do something soothing for yourself. Experiencing symptoms of hypervigilance, stress or distress are signals to discontinue this journaling exercise immediately. Take care of yourself by doing something like practice diaphragmatic breathing, reach out to a friend or loved one, or go for a walk to center and calm yourself. If you experience lingering negative feelings, you might benefit some additional help. It is recommended to seek the professional advice of a psychologist, counselor, or physician to discuss these feelings and experiences.
References
Baikie, K., Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment 11(5)
Batten, S., Follette, V., Hall, M., & Palm, K. (2003). Physical and psychological effects of written disclosure among sexual abuse survivors. Behavior Therapy 33(1)
Frisina, P., Borod, J., & Lepore, S. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. Journal of Nervous and Mental Disease 92(9)
Kovac, S., Range, L. (2000). Writing projects: lessening undergraduates’ unique suicidal bereavement. Suicide and Life-Threatening Behavior 30(1)
Lepore, S., Greenberg, M. (2002). Mending broken hearts: effects of expressive writing on mood, cognitive processing, social adjustment and health following a relationship breakup. Psychology & Health 17(5)
Niles, A., Haltom, K., Mulvenna, C., Lieberman, M., & Stanton, A. (2014). Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity. anxiety, stress, and coping. doi:10.1080/10615806.2013.802308
Pennebaker, J. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science 8(3)
Pennebaker, J. (2004). From Writing to Heal: A Guided Journal for Recovering from Trauma & Emotional Upheaval. New Harbinger Publications; Distributed in Canada by Raincoats Books.
Richards, J., Beal, W., Seagal, J., & Pennebaker, J. (2000). Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates. Journal of Abnormal Psychology 109(1)
Schoutrop, M., Lange, A., Hanewald, G., Davidovich, U., & Salomon, H. (2002). Structured writing and processing major stressful events: a controlled trial. Psychotherapy and Psychosomatics 71(3)
Smyth, J. (1998) Written emotional expression: effect sizes, outcome types, and moderating variables. Journal of Consultative Clinical Psychology 66(1)
Smyth, J., Hockemeyer, J., Anderson, C. (2002). Structured writing about a natural disaster buffers the effect of intrusive thoughts on negative affect and physical symptoms. The Australasian Journal of Disaster and Trauma Studies.
Spera, S., Buhrfeind, E., Pennebaker, J. (1994). Expressive writing and coping with job loss. Academy of Management Journal 37(3)
van Emmerik, A., Reijntjes, A., & Kamphuis, J. (2013). Writing therapy for posttraumatic stress: a meta-analysis. Psychotherapy and Psychosomatics 82(2)
