Writing As Therapy
Shonnie Brown, MFT

Recently I participated in a conference facilitated by Kathleen Adams, a psychotherapist and Registered Poetry/Journal Therapist specializing in "Journal Writing as a Therapeutic Tool." Author of the best-selling "Journal to the Self", Ms. Adams also founded the Center for Journal Therapy in Denver at www.journaltherapy.com thus gaining national prominence in the field of therapeutic writing. Her approach is both structured and self-directed--effective in working with depression and anxiety, trauma, abuse, grief and loss and other clinical issues.

The writing exercises, which I'm incorporating into my practice, range from simple and concrete to more unstructured and intuitive. Such a range allows for the therapeutic work to be tailored to a client's individual pace and need for containment vs. unboundness. The following client situations illustrate how therapeutic writing may be used during the therapy session:

Sexual Abuse: Mary, a sexual abuse survivor, has lost the memory of large portions of her childhood due to the trauma of childhood sexual abuse. In her healing, my job is to increase her feeling of control while she builds a safe narrative in the present through simple and concrete writing exercises such as:

"Today I want to work on..."
"My take aways from this session are..."

Giving Mary brief, structured daily writing exercises helps her build a consistent narrative now, fostering continuity and self-management in present time. When she feels safe enough to explore the trauma, we dip into it at her pace through time limited writing to be shared with me and reviewed together. Then the writing journal is closed and put away until the next time. Structure, containment, pacing and control all help Mary in her fear of being flooded and overwhelmed.

Social Anxiety: With Arthur, a socially anxious client, I've noticed that after a year of working together, our sessions are becoming mostly check-ins and conversation. Because he continues to come, I know Arthur feels safe here, but lacks focus and self-direction. A homework assignment to write a list of things he wanted to focus on in therapy caused Arthur to really think about how he wanted to structure his time and what he wanted to create in therapy. He put things on the list that we had never talked about. From there, brief writing exercises created focus without overwhelm. Longer structured writes then helped him to name the problem, dig deeper and create an action plan. Many socially anxious adults never felt guidance from their parents, are lacking in goal-setting skills and feel deep shame with open communication. Structured writing serves as a bridge for them.

Depression and Unresolved Childhood Trauma: Deep shame and fear of overwhelm require therapeutic containment and client control. Margaret is frightened by her story. She has spent years avoiding feelings, but now depression engulfs her. "I know I have to go there, but I'm terrified of what I'll find," she tells me. Thus, we work with very structured brief writes to increase containment, such as:

"Today I feel __________ about being here."
"This week I felt __________ when I recalled our last session."

We then review her writing, noticing the inner critic's voice and doing reality checks together, such as: "But wait a minute. The truth today is..." Writing helps provide task-orientation and structure for someone feeling immobilized by depression.

Severe Trauma and Ego Fragmentation: Some people suffer such debilitating trauma that their ego structure (the way they hold themselves together) is always vulnerable to fragmentation under stress. Mark is well aware of his vulnerability to psychosis under stress and our sessions always include a review of self-management skills. So with Mark I encourage frequent use of two simple exercises--list making and word clustering. Daily "to do" lists, worry lists, gratitude lists and lists of successes are all self-soothing and help create a sense of order when life feels out of control.

Clustering--drawing a visual map of thoughts and associations--may help a client to see their day or their situation in a new way or to get unstuck, to feel more control or to feel completion with an issue or a day. Simply drawing a circle around the written thought is containing in itself.

Inner Growth: The higher rungs of Kathleen Adams' "Journal Ladder" move towards unbounded free writing, requiring a stronger sense of self. My clients have enjoyed dream recall, dialogs and writing from their inner wisdom--all exercises designed to develop the ability to speak from and listen to one's own inner voice. Dialog is written communication between two voices--usually opposing, one often an inner critic--and is helpful in accepting inner polarity and paradox. Dreamwork offers powerful unlimited access into one's unconscious mind. Inner wisdom exercises dialog with one's higher self, higher power or personal and archetypal wisdom figures.

For more information on the many uses of therapeutic writing, please check out the following websites:

The Center for Autobiographic Studies

Journal for You

About.com Journal Links

Gillie Bolton: Theraputic Writing

Linda Joy Myers, Ph.D


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