Journaling after brain injury: The therapeutic benefits

For centuries, people have found journaling beneficial and cathartic. But only recently have the emotional, mental, and physical health benefits of journaling been proven through research studies.

This section will introduce journaling and how it may be helpful to those that have experienced brain injury.

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What is journaling?

Journaling is the act of freely expressing yourself in your own private notebook, audio recordings, or videos.
Your journal is a safe space where you can be 100% yourself; you can discover and make sense of yourself and your experiences. You can also use your journal as a tool to help with growth and personal strength.

To journal is to write about your life – it is telling your story. Life-based writing is one of the most reliable and effective ways to heal, change, and grow.

-Kathleen Adams, author of Journal to the Self and Founder/Directory of The Center for Journal Therapy

You don’t need to be a ‘writer,’ have perfect penmanship or punctuation, or know how to spell. If you have thoughts, you can journal. You simply need to be who you are in the moment.

There are no rules when it comes to journaling. It is suggested that you date (day, month, year) every entry—and depending on what you want to achieve, there can be important guidelines—but your journal is your personal creation. You are in control.

With its many forms (hand-written, voice-recorded, typed in computers, websites, apps, and visual art), journaling is accessible to everyone. Journaling has become more popular, in part due to extensive research being done on the benefits of the practice. A vast amount of information exists to help guide you in your journaling purposes or goals.

Ultimately, journaling is an exploration of self: a reflection of you, your life experiences, and the era in which you live. It’s a life tool that may contribute to your health, happiness, and give you more compassion towards yourself.

Journaling after trauma: Research on the therapeutic benefits

For several decades, an increasing number of studies have proven that when a person writes about emotional and traumatic experiences, they may experience significant physical, mental health and behavioural improvements as a result.

One of the first researchers to empirically prove the scientific benefits of journaling (expressive writing) is Dr. James Pennebaker, Ph.D., an American social psychologist and lead researcher on Expressive Writing at the University of Texas. He has authored many studies and publications, including the book, Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval [1]. He conducted his original work on expressive writing and trauma in 1986 [2].

More research findings here
In Pennebaker’s original research [2], he assigned healthy undergraduate students to one of four groups: three groups wrote about personally traumatic life events for 15 minutes for four nights in a row while the fourth group wrote about unimportant topics. The researchers tracked the participants’ visits to the university health center over the next six months. They found that writing about traumatic events was associated with fewer visits to the health center.

The study showed people’s health and productivity improved when they wrote about traumatic experiences or uncertainty—particularly if they constructed causal accounts or plans. Pennebaker found that translating our experiences into our own written language makes the experience more understandable. Pennebaker says, “Emotional upheavals touch every part of our lives. These things affect all aspects of who we are — our financial situation, our relationships with others, our views of ourselves and writing helps us focus and organize the experience.”

Since the initial experiment, the concept has been utilized in many studies of physical health and biological outcomes after journaling. Analyses of these studies confirmed the original finding: expressive writing is generally associated with better health.

A more recent study (presented in a conference paper and submitted for publication, Pennebaker, Keith Petrie, Ph.D., and others) at the University of Auckland in New Zealand found a similar pattern among HIV/AIDS patients. Patients who wrote about life experiences measured higher immune functioning than the control group. This suggested that journaling reduced their stress by releasing their illness-related anxiety. “By writing, you put some structure and organization to those anxious feelings,” he explains. “It helps you to get past them.”

Behavioural changes have also been researched as a result of journaling. Students who write about emotional topics have shown improvements in grades. Senior professionals laid off from jobs get new jobs more quickly. University staff members who write about emotional topics are subsequently less absent from their jobs. The article, Emotional and Physical Health Benefits of Expressive Writing [3] offers the following about outcomes of expressive writing:

Immediate and longer-term effects of expressive writing

The immediate impact of expressive writing is usually a short-term increase in distress, negative mood and physical symptoms… However, at longer-term follow-up, many studies have continued to find evidence of health benefits in terms of objectively assessed outcomes, self-reported physical health outcomes, and self-reported emotional health outcomes.

Long-term effects of expressive writing [4]

Health outcomes
  • Fewer stress-related visits to the doctor
  • Improved immune system functioning
  • Reduced blood pressure
  • Improved lung function
  • Improved liver function
  • Fewer days in the hospital
  • Improved mood/affect
  • A feeling of greater psychological well-being
  • Reduced depressive symptoms before examinations
  • Fewer post-traumatic intrusion and avoidance symptoms
Social and behavioural outcomes
  • Reduced absenteeism from work
  • Quicker re-employment after job loss
  • Improved working memory
  • Improved sporting performance
  • Higher students’ grade point average
  • Altered social and linguistic behaviour

Why does writing work?

Perhaps the main reasons for the benefits of journaling are simple: the value of using the written word to express oneself and the act and relief that comes from disclosure that is as honest as possible.
Another explanation is that the act of converting emotions and images into words changes the way you think and organize thoughts.

Journaling after brain injury – Telling your story

“We make our lives bigger or smaller, more expansive or more limited according to the interpretation of life that is our story.”~ Christina Baldwin, Storycatcher: Making Sense of Our Lives Through the Power and Practice of Story

One of the best ways to know and understand the events of our lives and their impact on us is by using a centuries-old, uniquely human and innate skill that we all have: storytelling.
In Forming a Story: The Health Benefits of Narrative by James W. Pennebaker and Janel D. Seagal [5], the authors state,

…constructing stories is a natural human process that helps individuals to understand their experiences and themselves. This process allows one to organize and remember events in a coherent fashion while integrating thoughts and feelings. In essence, this gives individuals a sense of predictability and control over their lives. Once an experience has structure and meaning, it would follow that the emotional effects of that experience are more manageable.

Following a brain injury, whether mild, traumatic, or non-traumatic, your life and world change. There is a great deal to make sense of. Pennebaker and Segal tell us that journaling in the form of storytelling can help: “Constructing stories facilitates a sense of resolution, which results in less rumination and eventually allows disturbing experiences to subside gradually from conscious thought.”

Barbara Stahura, a Certified Journal Facilitator, is the primary author of After Brain Injury: Telling Your Story [6], the first journaling book for people with brain injury. In this book, she offers the following.

As a person with brain injury, you have been hurt and traumatized by something most people haven’t experienced and can’t understand. (No matter how you suffered your brain injury or what type it is) you now must deal with a number of challenges you never expected or imagined. One major challenge you face is making sense of a life disrupted and perhaps altered forever. Another is being accepted as a person who still has value and whose life still holds meaning and purpose. Yet another us revealing a new self to people, perhaps even your loved ones, who don’t realize or understand the change the injury caused you (changes you may not understand, either). Since every brain injury is as unique as who experienced it, you will face individual hurdles. However, no matter how many challenges your brain injury create for you, one thing is certain: You have a new story to tell.

In the book, Expressive Writing, Counseling and Healthcare [7], author Barbara Stahura writes, “For many people with brain injury, the old story is gone or greatly changed.” Journaling can be a tool that helps a person find their new normal post-injury and explore the next chapter.

In Brainlash, Maximize Your Recovery from Mild Brain Injury, author Gail L. Denton, Ph.D. [8], who suffered a brain injury in 1991, writes, “My journal… was my way to reach inside and pull out my Self so that I could look at her and begin to figure out the new her! This woman was experiencing and expressing thoughts and emotions that the old me did not easily recognize as being ME. I wanted to know what was going on. I wanted some understanding, if not control. Journaling was my way to make sense of my predicament.”

Journaling can become a therapeutic and helpful tool for recovery and daily living.

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