Why Is Writing In A Journal Therapeutic

On April 1, I had been quarantining in my downtown apartment for two weeks, and it was starting to become clear that this coronavirus thing wasn't going away anytime soon.

As I often do in tough times, I turned to journaling. I decided I'd keep a record of my quarantine life through the month of April, a way to remember this crazy historical moment and process my feelings.

Now it's August, and my daily journal continues. I've left my building about two dozen times since I started journaling, so its contents aren't all that exciting—tidbits of everyday life, news about social distancing rules and reopening stages, moments of worry and loneliness and cabin fever and gratitude.

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I know I'm not the only one with a pandemic journal. In fact, hundreds of people have written journal entries on the Pandemic Project website, a resource created by psychology researchers that offers writing prompts to help people explore their experiences and emotions around COVID-19.

At a time when the days blend into each other, journaling is helping people separate one from the next and clear out the distressing thoughts invading our heads (and our dreams). Research also suggests it might be helping our health and immune systems, the very things many of us are worried about.

Although there are some pitfalls to journaling—ways of doing it that might backfire—it's one of those rare and valuable mental health tools that doesn't require you to leave your house or even see another human being.

The power of opening up

People had been keeping diaries long before scientists thought to put them under microscopes. But in the past 30 years, hundreds of studies have uncovered the benefits of putting pen to paper with your deepest thoughts and feelings.

According to that research, journaling may help ease our distress when we're struggling. In a 2006 study, nearly 100 young adults were asked to spend 15 minutes journaling or drawing about a stressful event, or writing about their plans for the day, twice during one week. The people who journaled saw the biggest reduction in symptoms like depression, anxiety, and hostility, particularly if they were very distressed to begin with. This was true even though 80 percent had seldom journaled about their feelings and only 61 percent were comfortable doing so.

Why do we avoid journaling?

For one, it isn't always pleasant; I know that I sometimes have to force myself to sit down and do it. Cathartic is probably a better word. In fact, some research suggests that we can feel more anxious, sad, or guilty right after we write.

But in the long term, we can expect to cultivate a greater sense of meaning as well as better health. Various studies have found that people who do a bout of journaling have fewer doctor visits in the following half year, and reduced symptoms of chronic disease like asthma and arthritis.

Can your diary keep you healthy?

Other research finds that writing specifically boosts our immune system, good news when the source of so much stress today is an infectious virus.

One older study even found that journaling could make vaccines more effective. In the experiment, some medical students wrote for four days in a row about their thoughts and feelings around some of the most traumatic experiences of their lives, from divorce to grief to abuse, while others simply wrote down their daily events and plans. Then, everyone received the hepatitis B vaccine and two booster shots.

According to blood tests, the group who journaled about upsetting experiences had higher antibodies right before the last dose and two months later. While the other group had a perfectly healthy response to the vaccine, the authors write, journaling could make an important difference for people who are immune-compromised or for vaccines that don't stimulate the immune system as well.

"Expression of emotions concerning stressful or traumatic events can produce measurable effects on human immune responses," write the University of Auckland's Keith J. Petrie and his colleagues.

Journaling could also boost our immune system once we've been infected with a virus. In another study, researchers recruited undergraduate students who tested positive for the virus that causes mononucleosis, which persists in the body after infection and has the potential to flare up. Three times weekly for 20 minutes, some wrote about a stressful event—like a breakup or a death—while others wrote about their possessions.

Based on blood samples taken before and after, writing about stress increased people's antibodies—an indication that the immune system has more control over the latent virus in the body—compared to more mundane writing. It also seemed to help them gain a deeper understanding of their stress and see more positives to it.

Why journaling works

What's the secret to the humble diary? It turns out journaling works on two different levels, having to do with both our feelings and our thoughts.

First, it's a way of disclosing emotions rather than stuffing them down, which is known to be harmful for our health. So many of us have secret pain or shame that we haven't shared with others, swarming around our brains in images and emotions. Through writing, our pain gets translated into black-and-white words that exist outside of ourselves.

"I'm able to organize thoughts and feelings on paper so they no longer take up room in my head," says Allison Quatrini, an assistant professor at Eckerd College who has been journaling for years and started a COVID-19 journal in April. "If I get them out on the page and clear the mental decks, it sets up the rest of the day to not only be more productive but be more relaxed."

On the thinking level, writing forces us to organize our experiences into a sequence, giving us a chance to examine cause and effect and form a coherent story. Through this process, we can also gain some distance from our experiences and begin to understand them in new ways, stumbling upon insights about ourselves and the world. While trauma can upset our beliefs about how life works, processing trauma through writing seems to give us a sense of control.

"Journaling is a tool to put our experiences, thoughts, beliefs, and desires into language, and in doing so it helps us understand and grow and make sense of them," says Joshua Smyth, a distinguished professor of biobehavioral health and medicine at Penn State University, who coauthored the book Opening Up by Writing It Down with pioneering journaling researcher James Pennebaker.

How to start a journaling practice

While you can journal in many different ways, one of the most well-studied techniques is called Expressive Writing. To do this, you write continuously for 20 minutes about your deepest thoughts and emotions around an issue in your life. You can explore how it has affected you, or how it relates to your childhood or your parents, your relationships or your career.

Expressive Writing is traditionally done four days in a row, but there isn't anything magical about this formula. Studies suggest you can journal a few days in a row, a couple times a week, or just once a week; you can write for 10 or 15 or 20 minutes; and you can keep journaling about the same topic or switch to different ones each time.

For example, the Pandemic Project offers several prompts to inspire your writing. You can write a basic entry about your general thoughts and feelings around COVID-19, or dig into more specific topics like the following:

Social life: How is your social world changing, how does that make you feel, and how are you handling it?
Work and money: How do you feel about your financial situation, and how has your job changed?
Uncertainty: Where is your anxiety and sense of uncertainty coming from, and how can you cope with it?

"Many people often start writing about COVID-19 and then begin writing about other topics that are bothering them more than they thought," notes the Pandemic Project website, which was created by Pennebaker and his research team. "This is what expressive writing is good for. Use it to try to understand those problems that are getting under your skin."

In my journal, I've found myself exploring the issue of control. My constant instinct is to organize and plan out life, but that's been impossible in the midst of a massive, unpredictable crisis. Journaling also let me ponder the lessons I want to take away from this experience around flexibility, acceptance, and letting go.

The do's and don'ts of a diary

A 2002 study does suggest that journalers should beware of rehashing the same difficult feelings over and over in writing.

In the experiment, over 120 college students journaled about a stressful or traumatic event they were experiencing, like troubles at school, conflicts with their partner, or a death in the family. They were instructed to write for at least 10 minutes, twice a week, over the course of a month. Some students wrote about their deepest thoughts and feelings—including how they try to make sense of the stress and what they tell themselves to cope with it—while others wrote about their feelings only.

During the month, the group who wrote about feelings and thoughts experienced more growth from the trauma: better relationships with others and a greater sense of strength, appreciation for life, and new possibilities for the future. They seemed to be more aware of the silver linings of the experience, while the group who focused on emotions expressed more negative emotions over time and even got sick more often that month.

The point here is that the most effective journaling moves from emotions to thoughts over time. We start expressing our feelings, allowing ourselves to name them; after all, jumping to thoughts too quickly could mean we're over-analyzing or avoiding. But eventually, we do start to make observations, notice patterns, or set goals for the future.

This has been the case for Allison Quatrini, who usually writes for a half hour in the morning about whatever's going through her mind—from the losses she's experiencing during the pandemic to her work or romantic relationship. It allows her to put into words how much her life has been disrupted, normalize the range of emotions she's been feeling, and brainstorm ways forward.

"It helps me make sense of the way that I'm feeling right now," she says. "Why do I feel not very motivated, why do I feel bored, why do I feel sad? It's also useful in admitting to myself what is going on [and] why it's been very challenging to deal with this."

In addition to writing, you might also consider adding drawings to your journal. In a 2003 study, people either journaled, made drawings, or journaled and drew about a negative experience from the past that still upset them, like relationship troubles or loss. According to surveys before and after, the group who wrote and drew saw the biggest improvements in their mood after three weekly, 20-minute sessions. Drawing without writing actually made people's moods worse, though. The researchers speculate it may have dredged up difficult feelings without offering a way to process them.

If writing is challenging, speaking your feelings aloud may work just as well. In that mono study, there was another group of students who recorded themselves talking about their stress. This group ended up showing the strongest immune responses to the dormant virus in their bodies. They also seemed to be doing the best psychologically, gaining insight and a positive perspective on their stress, improving in self-esteem, and engaging in healthier coping strategies. The researchers suspect that talking—even to a voice recorder—may feel similar to sharing our feelings with a loved one.

Freedom of expression

Sharing with a trusted confidant might seem even better than writing down feelings, as it serves a similar purpose and offers us warmth and validation that a piece of paper can't provide. And that's probably true, write Pennebaker and Smyth in Opening Up by Writing It Down.

One study, for example, found that people who talked to a therapist for four short daily sessions showed more positive emotion and less negative emotion. They gained understanding and perspective, and they made healthy behavior changes similar to people who journaled.

Therapy also seemed to be less unpleasant than writing. In fact, when Pennebaker originally envisioned journaling as a mental health exercise, he was inspired by the benefits of therapy—but mindful that not everyone has the means or the inclination to talk to a professional about their problems.

Of course, confessing to friends or partners isn't without its complications. Sometimes our loved ones are overloaded by their own stresses, or they can't offer the right kind of support—and may even make us feel worse. Other times, our secrets feel too vulnerable to speak out loud.

No matter what, if we're talking to another human, our brains will be doing a constant calculation about what to say or not say, how they might react, and how we will be perceived, says Smyth. Confiding on paper can be a valuable alternative and a way to express ourselves with absolute freedom. Journaling lets us process secrets before we reveal them to others.

For Quatrini, who researches and teaches about China, the stress of the pandemic has an extra layer: With the disruption to U.S.-China relations and travel, she's concerned about the future of her research. The immensity of that loss and uncertainty—and how it was affecting her day-to-day feelings and relationships—only became clear to her when she wrote about it.

"My entire life has been turned upside down and I don't know if it will ever right itself," she says. "Without the journal, I think I would not have figured that out."