Working in home health for the past two years, I developed a disabling condition known as compassion fatigue, also known as secondary traumatic stress disorder. This web page by the administration for Children and Families explains it well.

In order to recover from secondary traumatic stress disorder, I had to take a lot of time off. I started reading The Artist’s Way by Julia Cameron, and writing in a journal helped a LOT with my mental health recovery. Journaling can be an inherently therapeutic activity. Julia Cameron recommends writing 3 pages every morning, but even doing a little bit each day helps.

So why is journaling helpful in mental health recovery, particularly from secondary traumatic stress disorder? Occupational therapists are always looking at activities and analyzing them to try to understand any potential therapeutic benefits of the activity, the meaning of the activity, and all the components of the activity/the skills we must use to perform it.

Let me break down how journaling worked for me as a self-care tool.

A huge part of the job in home health, and usually the most difficult part of helping our patients, is making decisions. How do we make decisions? We use our perception and executive function. Journaling is a very direct, accessible form of creative expression. Creative expression is inherently therapeutic.

… So why is creative expression so healing?

Creative expression is NOT just for children and artists. You can break it down like this:

–Perceiving stimuli in the external world and in your own mind and body

–Processing that information

Acting in response to what you’ve perceived and the new knowledge you’ve gained.

Examples:

-I love my mom, so I’m going to draw a picture of her.

-I miss my friend, so I’m going to write them a letter with little doodles on it.

So you can see exactly how this works on our perceptual skills/attention and our executive function.

Creative expression, if you’re in the right state of being, is as effortless as swatting a mosquito. You see and hear the mosquito, see it as a threat to your comfort (and skin integrity, haha), and then you swat it. Perception, processing, response. This is the very same sequence that occurs when we help our patients. 

With secondary traumatic stress disorder and burnout, we can become “numb” or feel nothing. This is our perception being shut off. We can’t feel.

When perception is shut off and we are not functioning well, inevitably there will be consequences for our patients, not to mention ourselves and our loved ones.

So how does journaling, specifically, exercise our capacities to perceive, process and respond in a meaningful way?

Journaling prompts you to notice phenomena you might otherwise not have perceived, and the writing process stimulates you to perceive that phenomena and more deeply process it. Journaling is a creative activity that helps you process information. It’s a wonderful tool for coping with stress because, by its very nature, it exercises your capacity for critical thinking, problem-solving, perception, executive function and imagination. It is good for health because it helps us digest our experiences or, as researchers Karen A. Baikie and Kay Wilhelm put it in their 2018 article “Emotional and physical health benefits of expressive writing,” published in Advances in Psychiatric Treatment, through the mechanism of cognitive processing: “It is likely that the development of a coherent narrative helps to reorganise and structure traumatic memories, resulting in more adaptive internal schemas.” 

Your perceptions are the link between your inner world and the outer world. Journaling is a way of both expanding your awareness and starting a conversation with yourself. It’s a tool for generating insight and also a way out of yourself.