Writing as Therapy

"I hear and I forget, I see and I remember, I write and I understand." Chinese Proverb

Jane's words:

I love reading and writing. I don't have the self-discipline to read much anymore, but mainly I love writing when I feel unsafe and weird. I am lucky to have an amazing family as well, and when I feel unsafe, I call my mom or my dad.

My friend who doesn't live with her family any more told me the other day that she hadn't talked to her family in months...I was baffled. I have to talk to my mom every day. I need to talk to her to get guidance.

I made a journal for my dad, which I don't think he has ever used. It's a prompt journal (more about this later), I made one for myself as well, and I have made it 2/3rds of the way through - I do it when I first wake up and when I go to bed, it's an unloading of thoughts.

It solidified inside me when I was in boarding school, and had a really difficult creative writing class, and I pushed myself to my creative limits. I saw what I could do and saw that this is something I really enjoy - for so long there was nothing I enjoyed in that way.

It's a total release. When my boyfriend and I were separated I was so sad.

We spent every single day together for 2 weeks and after he left the house was completely empty. I longed for him and the only thing that calmed me down was writing a really depressing letter - it was the only thing I could do to calm down.

I couldn't even go find my journal, I just found this piece of paper on the ground, and I wrote and wrote until I felt better.

WHY WRITE?

Jane and I chatted about how much we both love to write. I have been writing a lot lately about my childhood trauma using fiction as a way to give it a voice. It's hard to translate painful memories into words, but it is also freeing. There is something about seeing it on the page that contains it. For me, writing about traumatic memories helps diffuse or externalize them. In an article about working through depression, Dr. John Moore (a therapist) suggests looking back at what you have written can help you come to conclusions about what you are feeling and spark insight or greater understanding¹. Writing can also allow an escape from everyday problems. You can make your characters do whatever you want. Writing fiction can give you a sense of control when you feel like you have no control in your real life. Writing can also help give you a sense of order by getting distorted thoughts and feelings out of your brain and into a more organized form. In addition, you can share your writing with your therapist, which may give them additional insight into your issues².

Health benefits are another reason to write. Participants in one study wrote about their most traumatic memories for 15 minutes for four days in a row. They experienced better health outcomes for up to four months later³. Another study found better health evaluations for patients with asthma and rheumatoid arthritis after writing about stressful events⁴. Writing may even improve immune system functioning⁵. It certainly improves working memory and reduces overall stress⁶.

Writing therapy has been effective for many conditions and mental illnesses⁷:

1. PTSD
2. Anxiety
3. Depression
4. Obsessive-compulsive disorder
5. Grief and loss
6. Chronic illness
7. Substance abuse
8. Eating disorders
9. Interpersonal relationship issues
10. Communication skill issues
11. Low self-esteem

Other reasons to write? It's low-cost, easily accessible, versatile, and can be done on your own. What more could you want?

HOW TO

You can just start writing. Like Jane, you can grab a piece of paper off the floor and write until you feel better. There are many ways to get started with your writing: start a diary - write down the events of the day and how you felt about them; being an evening reflection journal, where you reflect on the day's events and ponder how you might have behaved differently or made better choices; try a gratitude journal or a goal-focused journal. The recovery.org website even gives examples of what an entry might look like⁶. What jump-started the process for me was reading a book from the 1990s called The Artist's Way. I bought the book at a used book store for $6, but you can see the gist of Cameron's work on her website⁸. It was suggested by my therapist, who supports my healing with EMDR (another article on allnurses here), and art therapy.

Whether you call it a journal or a diary, therapy or "just writing", there are tools out there to help make the experience more (or less - your choice) therapeutic. Just google writing as therapy and a bunch of great resources comes up. I explored a few from the Positive Psychology Program. Some differences between journaling and actual writing therapy⁷:

Here are some tips from Positive Psychology to get you started²:

1. Use whatever format works for you: composition book, computer, toilet paper
2. Decorate your journal if it helps (I do...super fun)
3. SET A GOAL to write for ___ every day - if you miss a day - forgive yourself
4. Decide ahead of time when and/or where you will write each day
5. Write down what makes you want to write in the first place
6. Don't focus on what to write about - just do it
7. Write as if no one is watching (or reading)

These are sample journal prompts. Jane bought a really nice journal and sprinkled prompts like this throughout to spark her interest in writing. There are also phone apps⁹ that can help you with this:

• Write a letter to yourself
• Write a poem
• Mind mapping - your problem goes in the middle, and branches represent different aspects of your problem
• Journal on a photograph
• Three things I am grateful for
• 100 things I love
• My favorite way to spend the day is...
• If I could talk to my teenage self, I would say
• I really wish others knew this about me

BARRIERS TO JOURNALING

I thought I ought to talk about reasons why we don't write¹⁰- you may struggle with one, all or none. I'm sure that someone out there is struggling and it's good to have some ideas.

1. I don't have time/this is stupid/writing is a waste of time.

I am just going to put this out there: we have time for what we value. Easy to say, hard to do, right (or should I say "write")? I am a believer in setting small achievable goals. Tell yourself you only have to write four days out of every week. Give yourself permission to write for five minutes each day. Tell yourself you only have to write for five minutes each day. You can write five words or 500 words. If it is something you value, you will find time to do it. I promise.

Rewards can also work. For some of us, it's the joy of having a streak of 32 days on a task app on our phone, for others it's something more tangible. My plan when I fill my whole comp book is to burn it. I am planning my first solo overnight hike as a way to celebrate 60 straight days of journaling. I am going to find a spot in Pisgah Forest, light a little fire, read through the pages, and throw them in - releasing all that "stuff" into the atmosphere. I will let you know how it goes - This first journal will be completely filled up by the end of the month.

2. I can't write.

You don't have to be a famous novelist to write. It's a mistake to think you have to have any talent to write. Writing is about writing, not about a product. By the way, who told you that you couldn't write? There's your first journal prompt. Write about that. You have to get out of your own way and keep writing until you can believe you can write.

What if your issue is, you finally sit down to write and nothing comes? Being blocked is a common problem. Write about how you are so blocked you can't write. The real key to writing is letting go. That brings me to the final barrier...

3. Fear.

What if someone reads my journal? What if I remember something I don't want to remember? What if I learn something I don't want to know about myself? What-ifs are huge barriers. Get a journal with a lock, keep your journal with you at all times, disguise that journal - make it look like a cookbook or an auto repair manual - whatever it takes to make it unattractive to the people you live with.

What works best for me is that I actually have two journals. I have my journal for important things - lists, things I want to remember about my kids, what to talk about at our next marriage counseling session (don't want to forget to tell the therapist that my husband actually remembered to pick up his underwear the other day). This primary journal is one that if I left it at the hardware store, and someone read it before returning it (yep, that happened), I wouldn't be totally destroyed. The secondary journal is a total stream of consciousness. I wake up every morning and I put on some meditation music, but instead of meditating, I write three pages. I write whatever I want to - whatever comes into my mind. I have almost filled one of those composition books that always come home at the end of the year in my kids' school bags. You know the ones. You had to buy them 6 comp books last fall, and for some reason, they only wrote in the first 10 pages of each one...so use them. I tear out the pages my kids used and save them if they are meaningful, and then use the rest of the notebook for my dark, ugly, embarrassing thoughts. It is incredibly refreshing to start my day after unloading all that stuff, and I also try to set an intention for the day- how do I want to be in the world? If I do write anything I want to save, I transfer it to the primary journal.

Below you will find a list of resources to jump-start your therapeutic writing. This is a great way to find some peace, and a wonderful resource to share with your patients. Writing is a therapeutic modality that has been used for years to promote healing and provide closure. I have become an addict. When I am not writing, I think about writing. I have seen it work wonders for people, but it can't work if you don't try it. What's holding you back?

References

1. 5 Ways Creative Writing Helps with Depression - 2nd Story Counseling
2. Writing Therapy: Using A Pen and Paper to Enhance Personal Growth
3. Baikie, K. A. & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment. 11, pg 338-346.
4. Smyth, J. M., Stone, A.A. Hureqitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Journal of the American Medical Association. 281, pg 1304-1309.
5. Murray, B. (2002). Writing to heal. Retrieved from: Writing to heal
6. Journaling as an Aid to Recovery
7. Farooqui, A. Z. (2016). Journal therapy. Good Therapy. Retrieved from Journal Therapy
8. The Artist's Way | Julia Cameron Live
9. The 1 Best Journaling Apps for 218
10. The Power of the Written Word: Barriers To Journaling | HubPages