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The Walrus
The Walrus
Anne Thériault

Does Journalling Actually Improve Mental Health?

In the fall of 1962, Sylvia Plath wrote to her mother, “I am a genius of a writer, I have it in me. I am up at 5 writing the best poems of my life. They will make my name.” Before then, she’d struggled to find her voice, writing verse that was stiff and sometimes derivative, but in the months after her separation from husband Ted Hughes, she was able to let go and charge headlong in a new direction. These poems, which would be published posthumously under the title Ariel, were vivid, furious, and personal—like formal versions of some of the most memorable passages from the journals she’d kept for more than half her life.

Plath began keeping a diary when she was eleven years old and continued to do so right up until her death in 1963 at the age of thirty. She wrote about everything: sex, school, her challenging relationship with her mother. A frequent topic was the tension between her drive to have a career and her desire to be an ideal wife and homemaker—passages about her publishing successes are written with just as much relish as those about the elaborate meals she cooked for her husband.

Plath used her journals to exult when things were going well, to scold herself when they weren’t, to push herself always to do more, and more, and more. She could be critical, and even cruel, toward herself. One passage from 1953 begins with the words, “Letter to an Over-grown, Over-protected, Scared, Spoiled, Baby.” But when I discovered her journals, the entries that I found most interesting were the ones in which she analyzed (obsessively, often unsparingly) her own feelings. I remember reading her diaries with a shock of recognition. I saw in them the same quality I saw in my own journals: the need to write through any and every experience to unravel its exact meaning.

I didn’t start keeping a journal as a conscious way of coping with stress, but it didn’t take long for me to figure out that, if I was in a bad mental state, writing everything out provided some relief. I now realize that that sense of unravelling, of pulling apart my feelings, is a form of therapeutic journalling. And while people have been chronicling their lives for thousands of years, journalling as a wellness practice has experienced a recent boom. As countries started locking down at the start of the COVID-19 pandemic, many people turned to journalling as a sort of therapy—a space to vent and lament over the challenges of living through unprecedented times. A representative of the California-based lifestyle brand ban.do told a reporter they saw a 37.5 percent increase in journal sales from the previous year in the first four months of the pandemic alone—a figure similar to those of other brands across the country, according to Vox.

Journalling can be a valuable tool, and it’s quickly become a very popular one. But if so many of us are working out our feelings in notebooks, shouldn’t we all be feeling a whole lot better?

Diaries, or journals, as we understand them today—that is, regularly kept records of someone’s life, thoughts, and feelings—first started in Japan in the tenth or eleventh century. In the West, they didn’t appear until the early modern period. Samuel Pepys, one of the best known early diarists, is probably most famous for his accounts of the Great Plague of London and the Great Fire (he even wrote about burying cheese and wine in his garden to save them from the flames), but he also included very personal passages, like descriptions of fights he had with his wife and details about his frequent infidelities. The latter type of entry was often recorded in French and/or Spanish; an example from 1666 reads, “And thence to the Abbey, and so to Mrs. Martin and there did what je voudrais avec her, both devante and backward, which is also muy bon plazer.”

Journalling continued to gain traction during the seventeenth and eighteenth centuries, but it wasn’t until the early nineteenth century, when several diaries—including Pepys’s—were published, that the practice really exploded. But while people have long used journalling as a processing tool, its formal use as a widespread therapeutic practice didn’t begin until 1966, when American psychotherapist Ira Progoff developed a program he called the Intensive Journal Method. Progoff had realized early on that journalling can have tangible benefits for mental health by reducing symptoms of anxiety and depression and boosting emotional regulation. Evidence also suggests that having a regular journalling practice can improve memory function.

Since Progoff’s time, many different systems of therapeutic journalling have been created. One of the best known is that of Kathleen Adams, author of the 1990 bestseller Journal to the Self.

Adams received her first diary (which she describes as “the kind with a lock you could pick with a bobby pin”) for Christmas when she was ten years old, marking the beginning of a lifelong practice. Years later, when she entered a master’s program in psychology and counselling at the Boulder Graduate School in Colorado, her use of her writing as a processing tool became so well known among her friends that they began asking her to teach them how to journal in the same way. She went through her old notebooks to see if she could pick out a few helpful writing techniques, turning her methodology into a twelve-hour workshop. The response was overwhelmingly positive. Adams had found her calling.

Not long after, Adams began working at a psychiatric hospital, running an in-patient journalling program for women with post-traumatic stress disorder, most of whom had experienced severe trauma beginning in childhood. Many of the women had tried journalling before but had struggled with feelings of re-traumatization when doing so.

“The number one thing that they told me was that, often when they were trying to write about their trauma and understand it, they described this process of falling off a cliff or going to a deep and dark place that they can’t get out of,” said Adams. “Many of them were doing stream-of-consciousness writing, but I realized that, in trauma work, what these women really needed was structure, pacing, and containment. At least to begin with.”

When Adams left hospital work and moved into private practice, she discovered that her journalling program wasn’t just helpful for people diagnosed with PTSD but was also an effective clinical model for all kinds of mental health issues. In fact, there are only a handful of people for whom Adams wouldn’t recommend journalling: people who are experiencing disordered thinking (that is, thoughts that aren’t rational to other people), since writing in that state can take them deeper into those thoughts; people with highly manipulative tendencies, as they’re no more likely to be honest in their journals than they are in real life; and, finally, people who are struggling with impulse control in a specific area (for example, trying not to drink or have a cigarette), since writing about what they’re craving can sometimes turn into rationalizing why they should give into it. Otherwise, she believes journalling can be a powerful tool for just about anybody.

In the years since Adams published her first book, therapeutic journalling has gained enormous popularity. You can now find resources that cater to just about any social condition. There are guided journals for soldiers, for Catholics, for students, for grieving parents, and almost any other group you can think of. The practice has been embraced by the larger wellness industry, and it’s not hard to see why: therapy is expensive, and notebooks are comparatively cheap. But, as in the case of many other things associated with the wellness movement, journalling for mental health can feel like a bit of a double-edged sword: it can be helpful, but it’s no substitute for proper care overseen by a licensed practitioner. It can also feed into the idea that if we can just buy the perfect notebook and invest in the right routine, all of our mental health problems will be solved.

I started journalling when I was eleven years old, which is also around the same time that I started to really struggle with feelings of hopelessness and unworthiness. My first diary was a bright-orange Hilroy notebook with a picture of a marten glued onto the front. I chronicled the social upheavals of my small group of friends and my own uncertainty about how to handle them. By the time I was in high school, I’d switched from lined notebooks to hardbound sketchbooks in dark colours, which seemed better suited to my adolescent scrawl. These days, I’m a sucker for Moleskine-style notebooks, though I still prefer them to be unlined.

I don’t follow any specific therapeutic formula. I just write my way through whatever stressful thing I’m experiencing until I’ve finally figured out how I really feel about it. Sometimes it turns out that I’m actually upset about something completely different than whatever set me off, and sometimes I just write in circles until I’ve exhausted myself. Either way, the act of sitting down and committing it all to paper gives me enough space from my original heightened state that I feel like I can take a breath. But that breath doesn’t last long—journalling offers me only a temporary reprieve at best. And I have to admit that after years of trying to navigate mental health care in Canada, I’m burned out on solutions that put more responsibility onto people just trying to survive.

To say that the system is broken feels glib but, for proof, look no further than the numbers. In 2019, the average national wait time between a general practitioner’s referral and an appointment with a psychiatrist was nearly eleven weeks, while the average wait time between the appointment with the psychiatrist and the beginning of treatment was nearly fourteen weeks. That means that the overall time between seeing your family doctor and beginning treatment is over six months. For some provinces, wait times are disproportionately longer—like in Nova Scotia, where it typically takes over a year to receive treatment.

For those who do manage to endure the wait time, the options are often limited when it comes to treatment. Talk therapy and/or counselling is not covered by any provincial health plans unless it’s done by a medical doctor or through a medical clinic, but such programs are few and far between. Meanwhile, the average cost of private psychotherapy runs upward of $100 per session. To state plainly, these are resources that are out of reach for many Canadians.

Beyond the issues of scarcity and cost, the system can be incredibly complex to navigate. Margaret Eaton, national CEO of the Canadian Mental Health Association, has told the CBC that it’s a “patchwork quilt” of services. If you have a primary care physician (and 6 million Canadians do not), you might start there for a referral, but that’s just the mouth of the labyrinth. Once you enter the system, you’ll likely face wait lists, assessments, tests, invasive personal questions, and piles of paperwork, all while you’re struggling with debilitating psychiatric symptoms.

So I’ll admit that I bristle a bit when discussions about mental health involve suggesting things like journalling to people who are struggling. Of course, everyone has some responsibility for their own health, and mood-boosting activities like going for walks, taking baths, or going to the gym certainly have their place in a daily routine. On the other hand, what does it say about our existing mental health support systems if so many people are left to cobble together their own solutions?

While Sylvia Plath’s writing is well regarded, she’s arguably most famous for her death by suicide. So often when we talk about Plath’s death, we can make it seem fated, inevitable. But the reality is that she was not passive in her crisis. In fact, she was doing everything she could to survive it. She wrote prolifically in her last months—letters to friends and family, part of a second novel, the poems she told her mother would make her name, and a final journal, which was destroyed posthumously by her husband.

What often gets left out of that part of her story is the fact that she was fighting to get care right up until her last days. She was attending regular doctor’s appointments. She was trying new medication. She was reaching out to friends for support. She was doing everything we tell people to do when they’re struggling with their mental health.

In her last days, Plath was on a wait list to receive in-patient psychiatric treatment. When her doctor had tried to have her admitted at several hospitals, he was told that all the beds were full. In the end, her writing couldn’t save her. She needed real, substantial medical care. A person alone with their journal can only do so much.

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