There are various tools we use in trauma therapy to help clients process and manage their thoughts and feelings. One of these tools is journalling. Journalling is the process of writing down one’s thoughts, feelings, and experiences to help put them in perspective and take an objective view, ultimately paving the way for healthy, effective problem-solving and emotional catharsis.[1]
Journalling is a type of experiential therapy and is also known as ‘expressive writing’. Recent research has found that journalling can help to ease the symptoms of anxiety and stress associated with post-traumatic stress disorder (PTSD)[2], an anxiety disorder that affects millions of people worldwide.[3]
What is Post-traumatic Stress Disorder?
PTSD was once considered only to affect veterans of war, but recent research highlights that PTSD is prevalent across many demographics.[4] PTSD develops in response to a single or repeated traumatic event(s), such as:
- Childhood abandonment or neglect
- Physical abuse in childhood
- Sexual abuse in childhood
- Exposure to domestic violence
- Exposure to combat in war
- Sudden grief or loss
- Motor accidents
- Natural disasters
PTSD can also occur in the form of complex-PTSD, or ‘C-PTSD’. C-PTSD usually follows adverse or traumatic experiences in early childhood, such as childhood abuse, where the perpetrator was a close family member such as a parent or guardian.[5] This type of PTSD is complex because it is tied to ruptured childhood attachment, which complicates both the condition and treatment.
Benefits of Journalling for Trauma
Recent research has shown that journalling can help clients with PTSD in a variety of ways. Journalling, or expressive writing, can help people understand and process PTSD symptoms such as anger and anxiety.[6] Trauma and PTSD impact our ability to effectively self-regulate our emotions[7], so writing about them on paper can offer valuable insight and perspective.
Physical stress and tension are also characteristic symptoms of PTSD.[8] Journalling can make a difference to our physical state by reducing tension in our body and promoting both physical and mental relaxation.
Other than the cathartic release of emotions and the reduced tension, journalling can promote post-traumatic growth.[9] We know that traumatic experiences overwhelm us and create deeply held post-traumatic stress, which jeopardises our physical and mental health and well-being. However, there can also be silver linings to our traumatic experiences.
On your path to recovery from trauma, you may learn lessons and gain insights that broaden your perspective on life itself, leading you to thoughts and epiphanies you may not have achieved without your trauma history. Journalling promotes post-traumatic growth by putting your experiences into perspective and allowing you to step outside of them. As such, journalling can foster in PTSD clients a sense of meaning and purpose, leading to significantly positive personal and therapeutic outcomes.
Research on Journalling for Trauma
There has been much research on the benefits of expressive writing as a tool for healing from trauma. One study conducted by Dr James Pennebaker, University of Texas, Austin, involved 46 college students.[10] The participating students were asked to journal about either personal traumas from their past, or trivial topics. They were instructed to write for 15 minutes every day for four days in a row each week.
After six months, the subset of students who journaled about their past traumas had made fewer visits to the campus health centre and required fewer pain-relieving medications than those who wrote about trivial topics.
More recent research highlights that expressive writing can reduce stress and anxiety in a variety of populations. One study reports that expressive journalling offered benefits to stressed and burned out caregivers of older adults with Parkinson’s Disease.[11] Another study found journalling to be highly beneficial for gay men who were suffering from stigma-related stress.[12]
Why Does Journalling Help with PTSD?
Thinking about a traumatic experience expressing our associated emotions is an important part of moving on from our traumatic past. Through expressive writing, it becomes easier to organise our thoughts and feelings and prescribe meaning to our traumatic experiences. By finding meaning, our suffering is reduced.
In some ways, suffering ceases to be suffering at the moment it finds a meaning.- Viktor Frankl[13]
Expressive writing improves our emotional regulation.[14] Through writing, we cultivate an intellectual understanding of our experience. We construct a story about what happened, which ultimately helps us break free from the cycle of spiralling thoughts and rumination about the experience. With an account on paper, it becomes easier to acknowledge what happened as part of the past and not something that is still happening today.
Opening up to oneself about a traumatic experience can make it easier to open up to others, such as one’s therapist. By fostering openness and willingness to communicate one’s experiences, the therapist-client relationship strengthens, and clients are far more likely to achieve positive therapeutic outcomes.
Timing is important. Research has found that those who engage in expressive writing in the immediate aftermath of a traumatic event may experience a worsening of their symptoms.[15] As such, Pennebaker recommends that expressive writing take place at least a couple of months after the experience. Waiting allows clients to better process the experience and gain some much-needed perspective.
The Journalling Process
To engage in the journalling process, clients are typically instructed to take the following steps.
- Find a quiet space
Find some quiet time and a comfortable, relaxing space to begin your journal. It is best to avoid distraction, such as a busy environment or having your phone near you. Still, don’t worry too much about finding the perfect space or time. For some, writing in a coffee shop or on a train can be just as peaceful and rewarding as writing at home.
- Take some time to reflect
Before you start writing, take a few minutes to reflect on how your past trauma has impacted your life. Consider how it has changed your perspective or behaviour.
- Write about your deepest thoughts and feelings
Reflect and write about the traumatic event you experienced. Ideally, write for 15-20 minutes consecutively. Don’t worry if you get stuck and can’t reach the 15-minute mark. This is a process, and writing takes practice. You may notice that after a few days of writing, it becomes easier to find a flow.
- Read what you wrote
Once you have completed a writing session, read back on what you wrote and check-in with how you feel. Notice any changes in mood or thoughts that have come from writing in your journal.
- Make a plan to manage distress
Naturally, writing about your past traumas is likely to bring up some uncomfortable or distressing feelings. If you are struggling with PTSD, we highly recommend that you seek a professional therapist’s help and guidance. If you are already seeing a therapist, it may be helpful to journal before a session. This way, you can manage any distress or discomfort that arises with the support of your therapist.
- Repeat
It is helpful to write about a given topic for three to four consecutive days. When you are consistent, it becomes easier to organise your thoughts and feelings about your trauma.
Journalling as A Complementary Experiential Therapy for Trauma
You may be surprised to discover the clarity that comes from journalling. Trauma and PTSD are complex conditions to live with. Journalling is by no means a cure-all approach, but it can be of significant benefit to your mental health and well-being. Journalling is a type of experiential therapy as are meditation, yoga, mindfulness, and exercise – all of which are excellent tools to help with trauma recovery.
These healing approaches work best when applied in tandem with professional therapy.
If you have a client, or know of someone who is struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
[1] Coulson, Debra and Homewood, Judi, Developing psychological literacy: is there a role for reflective practice?, Journal of University Teaching & Learning Practice, 13(2), 2016.
Available at:https://ro.uow.edu.au/jutlp/vol13/iss2/5
[2] Harvard Health. 2011. Writing about emotions may ease stress and trauma – Harvard Health. [online] Available at: <https://www.health.harvard.edu/healthbeat/writing-about-emotions-may-ease-stress-and-trauma> [Accessed 6 April 2021].
[3] Bisson, J., Cosgrove, S., Lewis, C. and Roberts, N., 2015. Post-traumatic stress disorder. BMJ, p.h6161.
[4] Bisson, J., Cosgrove, S., Lewis, C. and Roberts, N., 2015. Post-traumatic stress disorder. BMJ, p.h6161.
[5] Giourou, Evangelia et al. “Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?.” World journal of psychiatry vol. 8,1 12-19. 22 Mar. 2018, doi:10.5498/wjp.v8.i1.12
[6] Meshberg-Cohen, S., Svikis, D. and McMahon, T., 2014. Expressive Writing as a Therapeutic Process for Drug-Dependent Women. Substance Abuse, 35(1), pp.80-88.
[7] Shepherd, Laura, and Jennifer Wild. “Emotion regulation, physiological arousal and PTSD symptoms in trauma-exposed individuals.” Journal of behavior therapy and experimental psychiatry vol. 45,3 (2014): 360-7. doi:10.1016/j.jbtep.2014.03.002
[8] nhs.uk. 2018. Symptoms – Post-traumatic stress disorder. [online] Available at: <https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/symptoms/> [Accessed 6 April 2021].
[9] Wu, X., Kaminga, A., Dai, W., Deng, J., Wang, Z., Pan, X. and Liu, A., 2019. The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. Journal of Affective Disorders, 243, pp.408-415.
[10] Pennebaker, J., 2017. Expressive Writing in Psychological Science. Perspectives on Psychological Science, 13(2), pp.226-229.
[11] Beck, Sarah, “Expressive Writing as a Coping Mechanism for Caregivers of People with Parkinson’s Disease” (2016). Honors Theses. 120. https://digitalworks.union.edu/theses/120
[12] Pachankis, John E, and Marvin R Goldfried. “Expressive writing for gay-related stress: psychosocial benefits and mechanisms underlying improvement.” Journal of consulting and clinical psychology vol. 78,1 (2010): 98-110. doi:10.1037/a0017580
[13] Frankl, Viktor E. Man’s Search for Meaning: An Introduction to Logotherapy. New York: Simon & Schuster, 1984
[14] Lepore, S., Greenberg, M., Bruno, M. and Smyth, J., n.d. Expressive writing and health: Self-regulation of emotion-related experience, physiology, and behavior. The writing cure: How expressive writing promotes health and emotional well-being., pp.99-117.
[15] DeBrule, Daniel Scott, “The Effect of Writing as Exposure Therapy on PTSD Symptoms” (2008). Dissertations. 1139. https://aquila.usm.edu/dissertations/1139