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When searching methods to reduce stress and discussing my problems with people I know, it was suggested to me that I journal thoughts, that is write down what worries me elaborately on paper.

I started doing it and I felt my mind having less 'noise' and clearing itself over time. However, I can't seem to understand why this worked and I can't find any good sources which explains why this worked in simple terms. Here is a website discussing journaling.

The closest analogy I can come to for how it feels to journal is how it feels to have a complicated thought relating to mathematics, in my head it is difficult to work out the algebra and see how it plays out but I can easily work my thoughts if I have a paper at hand (and a calculator handy).

Hopefully someone can shed some light on what's going on here.

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    $\begingroup$ Interesting question, +1. When I have todo's running in my head at night and I can't sleep, the only thing that works out for me is basically writing them up, one by one. As if you lay each and every thought down to sleep to the effect that I finally can get some rest myself after the process. I'm curious to the answers. $\endgroup$
    – AliceD
    Mar 12 at 8:07
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    $\begingroup$ This is a great question. I don't have a grasp on the neuropsychiatric reasons that journaling has on stressful thoughts, but I agree intuitively that writing down concerns decreases "noise" by making the abstract more concrete, and it stands to reason that the abstract is more difficult to deal with than the concrete (e.g. how many times have you told yourself that something you dreaded wasn't so bad after all once it came to pass?) I wish I could explain it as well. It may have a lot to do with rumination and worry. $\endgroup$ Mar 12 at 17:25
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Short answer: Like much of psychotherapy in general, we mostly know that it works, but not so much about why it works.

Journaling or journal therapy is a type of writing therapy, itself a form of expressive therapy, that includes expressive, interactive, reflective, and creative writing. Several recent literature reviews and meta-analyses confirm the effectiveness of such practices at improving various mental health outcomes (Travagina, Margola, & Revenson, 2015; Santini & Waterhouse, 2012; Harris, 2006; Merz, Fox, & Malcarne, 2014; Nakashima & Gallegos, 2020; Ruini & Mortara, 2021). However, the effect of writing on stress appears to be non-significant (Frattaroli, 2006; Zachariae & O'Toole, 2015; Oh & Kim, 2016; Qian et al, 2020; Nyssen et al, 2016; Mogk et al, 2006), except for post-traumatic stress disorder (Dawson et al, 2021; Gerger et al, 2021; van Emmerik, Reijntjes, & Kamphuis, 2013; Pavlacic et al, 2019). Additionally, in general when positive effects are reported, effect sizes are modest, vary substantially, include little long-term data, suffer from publication bias, and use inconsistent protocols.

Given the caveats in effectiveness, determining the mechanism of action is a challenge. A number of hypotheses have been proposed as to why these practices sometimes improve mental health outcomes, but in general they have not stood up to empirical validation on their own.

  • Inhibition hypothesis: Perhaps writing about topics otherwise inhibited can effectively result in a sort of cathartic release - seen in psychoanalysis as a mechanism for reducing stress.
  • Cognitive processing: Introspection and reflection are also a common mechanism of action proposed for typical cognitive therapies, providing an opportunity to process and reframe stressful events.
  • Self-regulation: The confidence-boosting effect of self-affirmation of emotional control, expression, and monitoring, may have a stress-reducing (buffering) effect.
  • Exposure therapy: Habituation is a common mechanism of action proposed in the treatment of post-traumatic stress, and writing is analagous to other exposure-based treatment modalities.
  • Emotion regulation: The use of language, emotion labeling, narrative, and perspective-taking, may facilitate emotion processing; though the reverse may also happen - where ability to process emotion leads to improvements in written expression.
  • Social dynamics: The effect of writing may happen after the fact - eg, it may encourage further sharing, improve communication faculties, and prompt significant life changes.

The actual explanation is likely complex and/or different for different people (Smyth & Pennebaker, 2008; Reinhold, Bürkner, & Holling, 2018; Sloan et al, 2015). As Pennebaker & Chung (2011) put it:

If you are expecting a clean and simple explanation for the effectiveness of writing, we have some very bad news: There is no single reason that explains it. Over the last two decades, a daunting number of explanations have been put forward, and many have been found to be partially correct. Ultimately, there is no such thing as a single cause for a complex phenomenon.

(Their review of proposed mechanisms, along with evidence that supports and undermines each, is the most extensive I've seen, so check out that chapter for more details. Another good one is Costa & Abreu, 2018.)

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Spoken language is the primary medium of counselling and psychotherapy. The therapeutic value of written language has also been studied extensively, both to provide self-help information and to elicit personal reflection (Miller, 2014).

There are two main kinds of journaling. There is interactive journaling, and there is reflective journaling.

Interactive Journaling

Interactive journaling is a guided writing process that combines both self-help information and personal reflection (Miller, 2014):

It has differed from usual therapeutic writing in two ways: (a) by integrating the presentation of treatment-relevant information in graphic-enhanced text to engage the reader, and (b) by offering frequent structured opportunities for the client to respond to and integrate material being presented.

Interactive journaling is very adaptable and can take many forms. Miller's account provides one form. You don't necessarily need to use "graphic-enhanced text" as he prescribes. The Wisconsin Department of Public Instruction (DPI) provides the following description of interactive journaling within education (DPI, n.d.).

INTERACTIVE JOURNALS provides students with a space to record their thinking about vocabulary words. There are a variety of formats for interactive journals, some with more structure than others. Educators should choose the journal that is most appropriate for the needs of the classroom and should check students' interactive journals and provide feedback to students regularly. Each time students engage with a vocabulary word, they should revisit their interactive journals, modifying their entries with their new understanding.

The following image gives some examples:

examples of interactive journals

The following citations were given regarding research:

  • Beck, I., McKeown, M. G., & Kucan, I. (2002). Bringing words to life: Robust vocabulary instruction. New York: Guilford.
  • Graves, M. (2008). Instruction on individual words: One size does not fit all. In A. E. Farstrup & S. J. Samuels (Eds.), What research has to say about vocabulary instruction (pp. 56–79). Newark, DE: International Reading Association.
  • Marzano, R. & Pickering, D. (2005). Building academic vocabulary. Alexandria, VA: Association for Supervision and Curriculum Development.

Interactive journaling as described by the DPI can be adapted for use in therapy where in person centred or integrative psychotherapy, the therapist and client should collaborate to choose the journal style that is most appropriate for the needs of the therapy. In pure psychodynamic therapy, the therapist will decide according to the requirements of the way the therapy is going.

Interactive journaling can be great for writing down what you are grateful for as suggested by @WinstonL. The client can either use the journal to review their thoughts within therapy by sharing it with their therapist, or the client can review it outside the therapeutic space by re-reading it, and modifying it as therapy continues.

Reflective Journaling

Reflective journaling was made part of my training as a psychotherapist. Although it is a different model of journaling, it can incorporate some of the styling of interactive journaling, although the information is never altered.

Although used widely throughout counselling psychology and other training programs that incorporate experiential activities, reflective journals have sparse, fragmented and non-comparable theoretical bases to support their use (Hubbs & Brand, 2005). Although the term reflective journaling means something slightly different, referring to journals as paper mirrors within Hubbs and Brand's 2005 title is a good analogy on the idea of reflective journaling.

Reflective journals put in writing exactly what you are thinking right in that very moment in time regarding one or more specific topics. As differing, incongruent or altered thoughts are found, another entry is made referring to the previous thoughts and the entry puts down in writing and/or images how those thoughts have changed or are incongruent.

All the entries are there to be read through in self-reflection and introspection, allowing you to examine whether your thoughts actually are a true reflection of reality.

With introspection, you are learning about your currently ongoing, or perhaps very recently past, mental states or processes (Stanford University, 2019). During introspection, the reflective questions to ask yourself should be (Open University, n.d.):

  • Strengths – What are my strengths? For example, am I well organised? Do I remember things?
  • Weaknesses – What are my weaknesses? For example, am I easily distracted? Do I need more practise with a particular skill?
  • Skills – What skills do I have and what am I good at?
  • Problems – What problems are there at work/home that may affect me? For example, responsibilities or distractions that may impact on study or work.
  • Achievements – What have I achieved?
  • Happiness – Are there things that I am unhappy with or disappointed about? What makes me happy?
  • Solutions – What could I do to improve in these areas?

Journaling is a very personal experience and can be very rewarding. You can do all this reflection and introspection alone, or you can do it with your therapist. Those suffering from stress, depression and trauma can look back at their entries and may choose to evaluate things with their therapist. Discussing the entries with your therapist can allow you to examine and reflect on them and work together to alleviate worries and anxieties.

Once that has been done, maybe another entry can made putting into writing the results of your evaluations at that time. Maybe you have uncovered prejudices you previously were not aware of. Write them down, and write how you feel about that. How do you feel you can change those views?

The whole process is ongoing and can be used just as part of therapy or it can even be used after therapy has concluded, as it counts towards your personal development. Your thoughts and their processes can often change over the years and reflecting back on those changes can show how you have developed your thoughts and beliefs.

Which is better?

Because journaling is a very personal experience, that is a very subjective question and depends very much on what you intend to get from your journal and how you wish to obtain it.

References

DPI (n.d.). Interactive Journals [Free PDF] https://dpi.wi.gov/sites/default/files/imce/ela/bank/6-12_L.VAU_Interactive_Journals.pdf

Hubbs, D. L., & Brand, C. F. (2005). The paper mirror: Understanding reflective journaling. Journal of Experiential Education, 28(1), 60-71. https://doi.org/10.1177/105382590502800107

Miller, W. (2014). Interactive journaling as a clinical tool. Journal of Mental Health Counseling, 36(1), 31-42. https://doi.org/10.17744/mehc.36.1.0k5v52l12540w218

Open University (n.d.). Self reflection https://www.open.ac.uk/choose/unison/develop/my-skills/self-reflection

Stanford University (2019). Introspection https://plato.stanford.edu/entries/introspection/

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As a person who has been journaling for more than twelve years ever since a very compassionate friend advised me to, I can attempt to answer why journaling seems to reduce stress.

AliceD mentioned that it's a way of writing down todos. That’s true. I also have Google Tasks for that.

The friend of mine deals a lot in algebra. We had spent a lot of time together working out mathematical problems, playing the guitar as well. It was thoroughly enjoyable to see him logically work towards the right answer. He believes in working things out by deriving from first principles.

We are quite religious so our journaling is quite spiritual in nature.

I didn't go into journaling knowing how good it would be, but looking back the benefits are invaluable.

Absolutely anything can go into your journal. I love to draw diagrams too.

In life we all make mistakes. I write down the fool things that I have done so that I can correct myself. Very often we do not know why certain people are antagonistic or get angry with us. This is because we are not omniscient like God. We do not know what the other person is thinking. By writing events down we are working out problems in our interactions with our fellow human beings. It greatly simplifies our thought processes. We can solve problems much more efficiently. We can improve our relationships with people.

I also write down what I am grateful for : https://www.oprah.com/spirit/oprahs-gratitude-journal-oprah-on-gratitude ;

I used to have a lot of ‘noise’ in my head. I would think about what people said in great detail. Often people tell me not to think too much. It’s those stressful experiences that get me thinking the most. By writing everything down, I’m offloading my thought processes into my journal.

I sincerely want to help the person who posted this question as I feel so much affinity towards the points in Buraian’s question. I hope that my answer would also help the community and people who chance upon this question. I wasn’t expecting to write content targeted at scientific journals so please forgive my very informal first draft. I read the guidelines that personal experiences are valid answers so that’s why I decided to answer this question.

References

Deaver, S. P., & McAuliffe, G. (2009). Reflective visual journaling during art therapy and counselling internships: A qualitative study. Reflective Practice, 10(5), 615-632.

Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Jama, 281(14), 1304-1309.

Jamison, S. G. (2007). Online law school faculty perceptions of journaling as professional development: Influences, barriers and pitfalls (Doctoral dissertation, Capella University).

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