Action 37

I use a “writing cure” of journaling; keep a running diary, blogging, social networking websites or testimony writing of what happened. I can write out the story of what I experienced, including any emotional “hot spots,” “stuck points,” and share these accounts with people I trust. Trauma resolved is a great gift that I can share with others. I can use the healing value of emotional expression. When people keep the trauma a secret then it can become toxic to one’s health and social relationships. Expressive writing can enhance adjustment and bolster resilience.

Useful Information

Sharing one’s account in the form of journaling or story-telling is the mind’s attempt to heal itself. Unresolved memories of trauma have to be talked about and re-experienced so they can be processed. Avoidance just keeps symptoms alive. Journaling permits you to relive the past while viewing it from the perspective of the present and helps you perform a “guided reconsideration.” Journaling permits you to become both a narrator and spectator of your life experiences. Like someone on the outside looking in, you can develop a perspective that you might not have had before.

Research by Jamie Pennebaker and his colleagues have found that when individuals engage in expressive writing about stressful and traumatic events it has a number of positive outcomes including medical consequences of reducing visits to doctors by breast cancer patients and migraine and respiratory sufferers, reduced absenteeism from work, improved grade point averages for students, and improved relationships and reduced PTSD and overall lowered levels of psychological distress in trauma victims. The writing out of a trauma narrative alone is not sufficient to improve psychological and physical health, but that it is also essential to integrate thoughts and feelings about the traumatic events into a consistent and meaningful account.

Expressive writing has been utilized with a variety of psychological problems (e.g. anxiety, depression) and stress resulting from medical diagnoses, job loss, and loss of a significant other (through death, relationship break up).

When individuals included in their expressive writing words that reflect insight, change and a search for meaning and causality, it propelled personal growth. Such words as “know, consider, understand, purpose” and “because, cause, effect” provide a basis for behavioral change. See Action #62 and #65 for a list of RE and Action verbs that you can include in your healing journal writing.

Developing a “coherent narrative” is an essential element of post-traumatic growth. Writing encourages you to make sense of your experiences and integrate what happened into your autobiographical memory. You can also use the expressive writing technique to journal about your reintegration experiences, not just your deployment experiences.

For practical advice on writing see: https://liberalarts.utexas.edu/psychology/faculty/pennebak#writing-health

Pennebaker suggests that you write for at least fifteen minutes a day for four consecutive days. You can also keep a written diary of what is going well.

Recently, Pennebaker created an expressive writing portal, The Pandemic Project (www.exw.utpsyc.org), with exercises and resources for expressive writing.  It is an open exercise anyone can try, which provides a little feedback when completed.

Quotable Quotes

“Give sorrow words: the grief that does not speak; whispers the o’re-fraught heart and bids it break.”

—Shakespeare’s MacBeth

“What cannot be talked about can also not be put to rest; and if it is not, the wounds continue to fester from generation to generation.”

—Bruno Bettleheim

“I write in order to discover what I am thinking.”

—Joan Didion

“It takes a lot of courage to write down the traumatic experiences that you have had. It makes it more real.”

“As the words and emotions came pouring out, I realized this was my form of therapy.”

“When I started keeping this diary, at first I thought it would not prove helpful. What amazed me was that after a week I was able to fill up a couple of pages. When I read these items each night I realized I was on the road to recovery.”

“Give yourself permission to express your feelings in writing or talk them out with someone who can relate to what you feel. This is what I found was most helpful.”

Finally, it is worth noting that such expressive writing has been found to be helpful at both the individual and communal levels. For example, as part of the healing process in postwar Kosovo (which was previously part of Yugoslavia) and where a civil war occurred, they have created the Archives of Memory project, in which they collected stories of Kosovars following the war. Such shared, documented “story-telling” contributed to posttraumatic growth and resilience.

At the individual level, traumatized and victimized clients have used journaling in a treatment procedure called Cognitive Processing Therapy (CPT) (see www.cpt.musc.edu).

How To: Journal and Engage in Guided Reconsideration

Journaling can help individuals understand the meaning of the traumatic event, with an emphasis on identifying how the events changed an individual’s beliefs about self, other people, the world and the future. Journaling can help individuals identify and challenge “stuck points” which are the problematic beliefs and conclusions regarding the nature and meaning of the traumatic experiences. Journaling helps individuals to organize their memories of the trauma, develop a stronger sense of self-control and experience less distress in response to internal and external reminders.

  1. To begin with try and write out a page or two of what traumatic encounter(s) you experienced. Include as much detail about it as you can remember. Be specific as possible and include your deepest feelings about these events. The account should be written in the present tense. (Some have found that writing about negative events in the third person perspective is most helpful).
  2. You may wish to begin with “broad strokes” and then fill in the picture with specific details. For instance, what happened, what feelings you had, what thoughts you had when it happened, what anyone else said or did, and what you did right afterward?
  3. You do not have to do this all at once. It may take several attempts to get it all down.
  4. After you are all done writing, read your account to yourself at least once before sharing it with a supportive other like a counsellor or chaplain. You can repeatedly reread your narrative.
  5. If it is too upsetting to read all at once, try reading as much as you can, and then read the rest when you are able.
  6. Revisit your account and add what you did to survive and consider what lingers from this experience. What conclusions do you draw about yourself, about other people and about the future, as a result of this experience?
  7. The mere act of writing about upsetting events, especially if done on multiple occasions can reduce psychological distress over time.
  8. How do you now feel about what you have experienced since sharing this with yourself and supportive others?
  9. You can also journal about growth-related benefits that followed from the traumatic event.
  10. You can write about these events for fifteen to thirty minutes on three to five consecutive days.

Other Ways to Use Journaling and Letter Writing

  1. Write a supportive and encouraging letter to an imaginary friend who has experienced the loss of a loved one and who is facing difficulties. In the letter address the following questions:
    • Is it possible that your friend has learned something through the death of his/her loved one or through what happened after the loss?
    • Has he/she found out something about life which he/she would otherwise not have seen at all?
    • Is this knowledge useful in other areas of his/her life?
    • Has this experience changed his/her in a positive sense?
    • Can you use any of the answers you included in your letter on yourself?
    • You can write a “rainy day” letter to yourself indicating what changes you have made, “signs of resilience and recovery.” You can describe yourself sympathetically in the third person. This letter can be read when you feel the need.
  2. Write a letter from the future, namely, “as if” several years have passed including in your letter positive events that you would like to have happen, have indeed happened.
  3. Torture victims have written “testimonials” of atrocities they have experienced and shared in groups their accounts with other survivors. They have included in their testimonials what acts of justice they wish to pursue.
  4. Holocaust survivors have made video testimonials conveying their memories of events in order to leave a legacy. Healing through sharing. Consider the many war-torn accounts of combat that document the impact of trauma.

Journaling makes the thoughts and feelings about events more organized and coherent. Writing forces one’s thoughts to become more structured, less fragmented, fosters insight and reframing, acceptance and closure, perspective taking and problem-solving, nurturing hope.

Action 38