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Ask Dr. K: You can keep a journal to manage your stress

DEAR DOCTOR K: My therapist told me that regularly writing in a journal might help ease my stress and improve my mood. Is there any evidence to back this up?

DEAR READER: Yes, there is, if you are disciplined about it and do it the right way. Some of my patients and friends have kept a journal following a major and unexpected life stress — say, a cancer diagnosis, a car accident or a layoff. Others have been doing it most of their adult lives, not in response to a major life event.

What goes into such a journal? What do you write about? Whatever is on your mind and feels important as you begin to write. It might be about a problem you are currently dealing with. It might be about a significant event in your past. It might be about your family. It might also be about something wonderful — and why it is wonderful to you.

When you’re writing about a stressful life event, recording your thoughts can help you cope with the emotional fallout of such events.

Expressive writing may help if you struggle with ongoing depression or anxiety, but research suggests that it is more effective for otherwise healthy people who have suffered an emotional blow.

You asked about evidence. In one study, college students were divided into two groups. One group wrote about personally traumatic life events for 15 minutes on four consecutive days. The other group of students wrote about trivial topics.

Compared to those who wrote about trivia, the students who wrote about traumatic experiences used fewer pain relievers over the next six months. They also visited the campus health center less often.

How does writing help? The key may be in thinking deeply about the experience. When you’re writing, you’re likely to take a close look at the experience, put it in perspective and make connections to other aspects of your personal development.

Timing also matters. It may help to put some distance between yourself and a bad experience before writing about it. If you write about a stressful event immediately after it occurs, you may actually feel worse.

If you’d like to give expressive writing a try:

— Set a length of time to write, say 15 or 30 minutes.

— Set a schedule, such as daily for five days, or weekly for a month.

— Focus on a stressful experience.

— Write nonstop and freely (whatever comes to mind) during the time you’ve set aside.

— Don’t worry about grammar, punctuation or writing style.

— Try to explore and express your innermost thoughts and feelings without holding back.

— Keep the writing confidential, so you’re less likely to censor yourself.

There is always a lot of “stuff” rattling around in our brains — things we don’t understand, and know we don’t understand. That’s unsettling. Taking the time to reflect can settle that stuff and keep it from rattling around.

Whatever topic you choose as you begin to write, you are about to do something enormously valuable: You are about to spend more time with yourself.

Dr. Anthony Komaroff is a physician and professor at Harvard Medical School.

Send questions to Anthony L. Komaroff, M.D. through his website: You also can mail him in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106.


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