In Therapy

A user's guide to psychotherapy

Journaling in Therapy

Supersized therapy? Write on!

Some people do, some don't. I think it can make the difference between spending some time in therapy and truly being in therapy. It's the cheapest way to supersize your experience.

Last year's 21 Tips for Clients in Psychotherapy included this pointer:"Journalysis: Use a journal to reflect on your sessions and jot down things you notice about yourself during the week. It doesn't have to be the ‘Dear Diary' of your youth, just a place to record a few thoughts or feelings. It may help to bring it to session with you." I'd like to expand on that a little.

Therapy is more than attending a weekly appointment. It's entering into a period of introspection that can last weeks or years. The session is a time where many of the insights and observations happen, but it need not be limited to that hour. In fact, for the best results, it shouldn't (research validating this here). Clients are allowed introspect all they want between sessions, and writing is a great way to focus and articulate their thoughts and feelings.

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Not sure what to journal about? Consider one or more of the following:

  • What was covered in the last session.
  • What you'd like to discuss in the future.
  • What you're noticing about yourself this week.
  • What you'd wish for if you had three wishes.
  • Your dreams (keep the journal by your bed to get them while they're fresh)
  • How you feel about therapy and/or the therapist.
  • What you're feeling and thinking at the very moment you're writing. 
  • Your worries. Your blessings. Your goals. Your memories. Your writer's block.

The list can go on and on. The main thing is to make it manageable or you won't do it. Many an ambitious therapy journal (and PT blog, for that matter) begin with an elaborate, insightful first entry followed by a paragraph for number two, a scribbled sentence for the third and nothing else. You've got to pace yourself. Keep it simple.

I've seen clients journal by writing three words down on their phone. Others will spend 15 minutes per day writing freestyle (a la The Artist's Way). Some blog. Some use an online journaling program. Still others choose to go with the classic: the leather bound journal and an espresso in a dark corner of the coffee shop. Whatever fits your style.

It's not so much what you write about but that you take the time to write. Introspection takes practice, which requires time and effort. Bring it to session if you'd like, but just for highlights, not as a script - we don't want to do therapy with your journal. Write as if no one else will ever read it -- if you're writing for an audience you risk getting lost in the performance.

The benefits? First, you've just taken some time to look at yourself, which continues the flow of therapy and makes you more aware. Second, you've begun to organize what can seem like a bunch of disjointed material. Writing forces you to funnel disparate thoughts into one linear stream. Finally, you're keeping a record of your progress. People who journal for a few months are amazed when they look back to see where they were. Sometimes they're amazed at how far they've come. Other times they're surprised to find they're barking up the same tree.

A note on theory. Whenever I bring up journaling to my dyed-in-the-wool psychoanalytic colleagues they roll their eyes. Journaling organizes thoughts, while analysis is about sifting through the psychic clutter to reveal traces of the unconscious (via free association). To them, journaling smacks of CBT - they fear token economies and thought logs are soon to follow.

I maintain that journaling can work in harmony with psychodynamic therapy. In the case of classic analysis, the client comes three to five times per week. Part of this frequency is because of the sheer volume of material, part is because of the aim of making the analyst an object in the client's life - to facilitate the projections and transference. But another reason for this frequency is that the regular digging keeps the psyche open. Without a week to rebuild defenses, the walls are down for continuous poking and prodding.

I wouldn't recommend journaling for someone in analysis. They already do plenty of introspection, and yes, journaling might get in the way. But for the weekly client in psychodynamic therapy, journaling can help keep the process rolling, hold the defenses at bay and help the work flow from session to session. If someone spends 50 minutes in therapy Monday, then writes in her journal for a half hour on Wednesday and Friday, come next Monday she's still in the zone and ready to dive in.

This is what I mean by supersizing: journaling helps therapy extend beyond the session. If you forget about your issues for a week and pick them up when you enter the next session, it's likely nothing's changed in the meantime. If you journal in the interim, there's more chance for growth between sessions.

So here's my challenge. Dust off your cool Moleskine and use it for a month to see if it helps you and your therapy. If it doesn't, send it to me, I'll read it and post it on my blog. That's a joke.

By WG of Therapy Tales
**Last month an incredibly talented and insightful blogger/cartoonist named WG at Therapy Tales (also a fellow Top 10 Psychoanalysis Blogger, by the way) drew a cartoon inspired by "Journalysis" from the 21 Tips. If you have any interest in therapy (and if you're reading this, you do) I recommend you check out WG's work!

 

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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