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Trauma

Good Therapy Is Good Grieving

The power of journaling.

My training analyst frequently reminded me that good therapy is good grieving. In order to move forward in life, we must constantly tally our life ledgers as to what we have lost and gained. Moving through life involves coping with and integrating constant losses and gains. One of my patients (who I will call Robert for this blog post) who survived a traumatic brain injury along with multiple other physical injuries in a horrific car accident also gave me frequent reminders, “I may not be alright, but I am not all wrong either.”

Robert’s journal helped to highlight some of the distress he endured on his journey to recovery. The following entries from Robert’s journal graphically underscores some of his experiences in his dark nights of the soul he encountered. Most people cannot begin to fathom the depths of anxiety, depression and worry Robert and others like him experience following serious injuries from car accidents. Over 100 million American adults live in chronic pain which often results in serious states of depression.

I suggested Robert use journaling as an auxiliary to therapy as it has been found to be an effective therapeutic activity for many people. Beth Holloway and Gail Nelson at the University of Rochester Medical Center wrote about potential journaling benefits in managing anxiety, reducing stress, coping with depression, helping with prioritizing problems, fears and concerns, and tracking symptoms to identify emotional triggers. Karen A. Baikie and Kay Wilhelm reviewed a number of research studies which showed that writing about traumatic events has resulted in improvements in both physical and emotional health.

Here are some of Robert’s journal entries which chronicle the kinds of issues he was confronting.

Aug. 14. Wanted to cut grass but could not. Had to pay neighbor kid to cut. Had a hard time today, lots of pain in neck, back, hands.

Aug. 15. Needed help all day, had to shower, too much pain in neck and hands.

Aug. 17. Felt sick all day, just hurting.

Aug. 18. Hurting in neck, hands, and back. Can’t move right. Did not pay phone bill and other bills. Forgot. Not like me.

Aug. 20. Hurting. Could not wash good. Need help to wash and make up bed. Trouble laying on bed in hospital. Took medicine and felt sick.

Aug. 21. Grass needed cutting. Had trouble putting on clothes. Needed help. Went to doctor office and pain level is at 8. Hands are numb and tingly.

Aug 22. Upper back and hands hurting. Numb and tingly. Painful to sit.

Aug 23. Needed help in tub. Had to shave but hands hurting and numb. Back hurt and neck pain.

Aug. 24. Pain in neck and hands. Could not make bed or wash up properly. Took medication and felt a little better.

Aug. 25. Tingly hands. Neck hurting. Hands tingling. A lot of upper back pain. Neck and legs hurt too. Needed help bathing.

Aug. 26. Pain in neck and back. Sharp pain in left side of shoulder. Arm and fingers tingling. Got shot in neck by doctor.

Aug. 27. Couldn’t sleep. Was hurting in neck and upper back areas. Hands and arms tingling. Don’t feel right.

Aug. 28. Need help bathing. My neck and hands hurt. Took pain medication. Not helping much. Fingers tingling a lot. Can’t make up bed or iron my clothes. That’s not me at all.

Aug. 29. Numbness in hands and fingers. Pain in neck and back. Felt dizzy. Had to sit but back hurt.

Aug. 30. Need help bathing. Back pain. Leg pain. Fingers numb. Hands hurt. Could not put clothes on.

Sept. 1. Hands hurting and numb feeling. Very bad today. Took medication for pain in hands and neck.

Sept. 2. Sharp pain in back and neck. Left leg hurting and numbness in fingers and hands.

Sept. 3. Feeling very dizzy. Need help standing and getting up. Not feeling well today.

Sept. 4. Hands numb and hurting. Sharp pain in back and shoulder.

Sept. 5. Need help bathing. Very dizzy today. Headache and hands hurt.

Jumping ahead to November

Nov. 23. Going to doctor, cars look like they’re going to hit me.

Nov. 24. Holiday time and I don’t feel right at all.

Nov. 25. I wish I could get back to where I was before.

Nov. 26. I wish I could get back to where I was before.

Nov. 27. I want to play and laugh with my family and can’t.

Nov. 28. I forgot what day it was and started crying about it.

Nov. 29. I talked to my pastor about what was going on.

Nov. 30. Not sleeping.

Dec. 1. I feel sad today.

Dec. 2. I have not made love in a while.

Dec. 3. I wish I could remember like I use to.

Dec. 4. Don’t want to shop. I miss myself a lot.

Dec. 5. I hate taking meds for pain but I have to.

Dec. 6. Church was ok today although I felt dizzy all day.

Dec. 7. My neck hurts a lot.

Dec. 8. I’m tired today.

Dec. 9. I’m thinking stupid thoughts. What’s wrong with me today? I hate this medication.

Dec. 10. Had to keep looking at my notes to remember things.

Dec. 11. I don’t want to be sick. Help!

Dec. 12. I feel scared to drive.

Dec. 13. I wish I could understand like I used to.

Dec. 14. My neck is hurting a lot today. I just had to lay down.

Dec. 15. I’m getting mad as hell about nothing.

Dec. 16. What’s wrong?

Dec. 17. I know there are people who love me.

Dec. 18. I’m going to be alright.

Dec. 19. I’m going to be alright.

Dec. 20. I’m going to be alright.

In a few words each day, Robert communicated how difficult his life experience had become post-accident. His journal showed how ultimately by turning to simple positive self-talk he was beginning to take control of his thoughts and emotions.

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