A Science-Supported Journaling Protocol to Improve Mental & Physical Health

Journaling Protocol for Mental & Physical Health (00:00:00)

• The podcast focuses on a specific scientifically supported journaling practice.
• Over 200 peer-reviewed studies show its effectiveness in improving mental and physical health.
• Journaling can lower anxiety, improve sleep, boost immunity, reduce autoimmune symptoms, and enhance memory and decision-making.
• The method takes a small amount of time and can have lasting benefits.
• It is prominent within psychology and psychiatry but not widely known.
• The practice originated from research by Dr. David Spiegel and others.

Journaling & Confronting Traumatic Events (00:07:16) & Tool: Expressive Writing (00:11:25)

• The transformative journaling was developed by Dr. James Pennebaker in the mid-80s.
• Subjects were asked to write about their most traumatic experiences for 15-30 minutes without stopping.
• Instructions were to freely express feelings and thoughts, with no concerns for grammar or spelling.
• Writing could be done by hand or typed, with no difference in benefits observed.
• The content involved connecting the experience with one's personal history and its impact on life.
• Variations in writing duration (15-30 minutes) showed no significant differences in outcomes.
• The confidentiality of the writings was ensured, with an option for participants to discard them.

Morning Notes, Gratitude Journaling, Diary Journaling (00:14:38)

• The discussed journaling form differs from morning notes, gratitude journaling, and diary journaling.
• It involves writing about negative experiences rather than clearing mental clutter, expressing thankfulness, or detailing daily life.
• Autobiographical journaling is common and personal, often not shared with others.
• Despite potential benefits, the podcast emphasizes the specific protocol for improving mental and physical health.

Tool: Consecutive Writing Bouts; Trauma Definition (00:18:00)

• The discussed journaling protocol involves writing about one's most negative experience and often leads to strong emotional reactions, including distress and anxiety.
• Participants are advised to include a cool-down period after writing to return to a calm state before resuming daily activities.
• The protocol is intensive, with the same negative experience written about for 15-30 minutes on four consecutive days or once a week for a month.
• Trauma, as defined by Dr. Paul Conti, is an experience that modifies our brain and neural circuitry, impacting our emotional, behavioral, or cognitive functioning.
• Everyone has experienced stressors, which may constitute trauma, and journaling addresses these difficult experiences to elicit positive mental and physical health changes through processing.
• This type of journaling is a short-term yet intense psychological exercise.

Low Expressors vs. High Expressors (00:24:38)

• Individuals who undergo the journaling protocol tend to split into two categories: low expressors and high expressors, which are unrelated to introversion or extroversion.
• Low expressors use less descriptive language and exhibit less emotional and physiological distress while writing about their experiences.
• High expressors use more negative language to describe their feelings and show higher degrees of emotional turmoil and physiological stress indicators such as increased cortisol levels and heart rate.
• While high expressors experience a reduction in distress over successive writing bouts, low expressors show an increase in distress over time.
• Regardless of whether one is a low or high expressor, the journaling protocol benefits both groups, leading to reduced distress and baseline stress levels seen weeks, or even years, after completing the exercise.

Tools: Language, Vocabulary & Emotion; Analyzing Writing (00:29:29)

• Individuals vary in their ability to express emotions through speech and writing.
• Research by Pennebaker shows that language patterns reflect psychological and emotional states.
• Patterns of using negative or positive vocabulary words correlate with corresponding emotional states.
• The study "Natural Emotion Vocabularies as Windows on Distress and Well-being" focusses on natural language patterns rather than vocabulary knowledge.
• People with a broader vocabulary for negative emotions tend to have more depressive states, while the opposite is true for positive vocabulary.
• It's the frequent use of certain types of words that is more important than the knowledge of these words.
• After completing four writing sessions, it is instructive to analyze the language patterns used across entries, noting shifts toward more positive language use over time.

Tool: Writing Session Tips (00:35:02)

• Pennebaker's protocol suggests writing about facts, emotions at the time, and emotions now regarding a difficult experience.
• Incorporation of any links between the experience and past, present, or future events should be included, no matter how indirect.
• Writing in complete sentences is encouraged but perfect grammar is not necessary.
• The protocol emphasizes the health benefits of writing without self-censorship and not for an audience.
• Quality of writing for personal understanding is more important than for external consumption.
• Unprocessed negative experiences can impact mental and physical health, whereas the writing protocol may aid in neuroplasticity and psychological wellness, reducing anxiety and improving mood, sleep, and immune function.

Positive Mental & Physical Benefits (00:41:02)

• Over 200 quality peer-reviewed studies have confirmed significant and long-lasting physical improvements in individuals who engage in a specific journaling protocol.
• This form of writing can mitigate symptoms of major depression and post-traumatic stress disorder but is not a complete cure.
• Significant health metric improvements have been observed in people with chronic anxiety, insomnia, arthritis, cancer, lupus, and fibromyalgia.
• Individuals with fibromyalgia reported notable reductions in chronic pain that persisted over time.
• Participants with irritable bowel syndrome (IBS) experienced relief of symptoms compared to those with IBS who did not follow the journaling protocol.
• Control groups in these studies also wrote for 15 to 30 minutes about different, non-emotional content, establishing a scientific comparison to the experimental group practicing the specialized writing.
• The unique strength of this protocol is the focus on emotional writing content, contrasting with other studies that might compare physical exercise interventions to control groups with different variables.

Expressive Writing & Immune Function; Brain-Body Connection (00:46:45)

• Studies involving a specific writing protocol have shown positive effects on mental and physical health, including improvements in autoimmune conditions, anxiety reduction, and sleep patterns.
• These improvements are likely due to a constellation of physiological changes.
• One key study by James Pennebaker, among others, examines how writing about traumas affects immune function, specifically T-lymphocytes.
• Subjects doing the writing protocol had blood drawn before and 15 weeks after completing the writing exercises, showing monitoring that included psychological and physical assessments.
• High disclosers, who shared more in their writing, showed greater immune activation in response to an infection mimicking challenge compared to low disclosers and control groups.
• Findings from these expressive writing studies contribute to the broader understanding of psychoneuroimmunology, highlighting the connection between emotional state, writing, and immune system response.
• Pennebaker, who suffered from asthma, deduced a connection between emotions and physical health from personal experiences, leading him to pioneer studies on how induced negative emotional writing can result in positive health outcomes.
• The results question traditional views of separate body and mind functioning and suggest a counterintuitive approach: inducing a negative emotional state through writing might lead to positive changes in immune function and neuroplasticity.

Neuroplasticity, Prefrontal Cortex & Subcortical Structures (00:58:10)

• The writing protocol leverages neuroplasticity, which is the nervous system's ability to change with experience.
• Childhood experiences are passively imprinted on the brain, shaping its predictive abilities.
• Recounting traumatic events for the protocol requires factual details, emotional impact, and associations.
• Traumatic experiences can lower activity in the prefrontal cortex and increase activity in subcortical structures.
• The prefrontal cortex is responsible for planning, self-identity, and sophisticated thinking.
• The process of writing about trauma potentially adjusts the balance between prefrontal and subcortical brain activity.

Structured Writing, Trauma & Narratives; Truth-Telling (01:05:00)

• Neuroimaging studies show prefrontal activity decreases and subcortical activity increases when recalling trauma.
• Structured writing over time creates a coherent narrative and deeper engagement with the traumatic event.
• Increased truth-telling and narrative coherence during journaling are linked to heightened prefrontal cortex activity.
• Truth-telling about one's feelings and experiences is a key component of the protocol, aiding symptom improvement.
• The writing exercise can modulate the impact of stress and trauma on mental and physical health.

Neuroplasticity, Truth-Telling & Relief from Trauma (01:08:56)

• Recalling traumatic events can increase prefrontal cortex activity, despite stress usually decreasing it.
• Adult neuroplasticity is triggered by atypical states, high levels of catacholamines, and deep sleep or rest.
• Revisiting stress or trauma in detail paradoxically provides mental and physical relief through neuroplasticity.
• Coherent narratives help create understanding and relieve confusion associated with trauma.
• Lack of a coherent narrative about traumatic events leads to confusion and false correlations within the brain and body.
• Telling the truth with a structured narrative increases prefrontal cortex activity and its regulation of subcortical structures.

Honesty, Brain Activity & Narratives (01:15:32)

• Experiments show prefrontal cortex links to honesty and increased activity during truth-telling.
• Study with a die rolling game revealed that stimulating the prefrontal cortex increased honesty in participants.
• Persistent prefrontal cortex activity through truth-telling may lead to neuroplasticity and a coherent understanding of events.
• The dorsal lateral prefrontal cortex is implicated in the accurate reporting of experiences and the regulation of coherent narratives.

Overcoming Trauma & the Brain; Stress, Emotions & Honesty (01:22:01)

• Studies reveal that recounting traumatic experiences improves immune system function.
• The nervous system connects the body and brain, influencing autonomic nervous system activity.
• Prefrontal cortex organization of autonomic response lessens unnecessary activation, reducing anxiety and insomnia.
• Direct communication exists between the nervous system and immune system, with neural circuits affecting organs like the spleen.
• Recent literature recognizes the interconnectedness of immunology, brain science, and psychology.
• Journaling about stress or trauma induces beneficial mental and physical health changes, potentially through prefrontal cortex neuroplasticity.
• Expressive writing, which involves truth-telling and accompanying emotion, enhances the effectiveness of other therapies, expediting recovery from depression and PTSD.

Expressive Writing Protocol & Benefits (01:26:41)

• The journaling protocol by Pennebaker is free, time-efficient, emotionally intensive, and customizable over 4 days to a month.
• Over 200 studies show long-term benefits for mental and physical health.
• Journaling's impact on mind and body has been underdiscussed academically and in clinical practice.
• Writing should encapsulate the facts and emotions related to an event and personal truths.
• Writing is private; sharing should ideally be with mental health professionals to avoid thirdhand trauma to listeners.
• The process involves four 15-30 minute writing sessions about the same event, focusing on facts, feelings, and associations.
• Grammar is unimportant, but some coherence helps if reviewing the text later, identifying negative and positive words.
• It's normal to feel negative emotions after writing; timing for writing should consider this emotional response.
• If the protocol induces excessive stress, it is advisable to stop.
• The protocol can be applied to any stressful event, not necessarily the most traumatic.
• The data indicate lasting positive effects on mental and physical health from this form of writing.