Journaling is a very important part of recovery from TMS. Effective journaling can assist in managing/improving TMS symptoms. Journaling can also replicate the therapy experience (if done correctly!) to help alleviate symptoms.
Patients often say that it is difficult to find time to journal. However, it is important to realize, that with TMS journaling, it is the quality that matters and not just the quantity. It is better to write five meaningful sentences, rather than pages and pages of journaling that are not helpful (more on what that is shortly). If you still feel that you do not have time, then you can do the “mental equivalent” of journaling. Pause for a few moments and think about something that evoked feelings. It could be a childhood event or something that happened two minutes ago.
The goal of TMS journaling is to help one get to feelings that might otherwise be suppressed in your daily life. As we know from Dr. Sarno’s books, some feelings are repressed (so deeply buried that they may be difficult to access without a greater level of work or professional help). Other feelings are suppressed. Suppressed feelings may be those that we are “too busy” to process during the day, or feelings that we wish to minimize or simply ignore.
Journaling to improve TMS symptoms is different in some important ways from what one may think of as keeping a regular diary. These are some journaling guidelines that I convey to my patients.
- What you write is for your eyes only. The act of writing itself is what is mutative, or causes change. You do not have to keep a record of what you write. In fact, this is often contraindicated because if you are worried that someone else will read what you write, the writing is already less effective. If you are worried that someone will see what you write, type it on a computer and delete it when you are done; or write it on paper and then tear it up shortly thereafter.
- Write about your feelings and your perception of events. Many times patients get caught up in worrying whether what they are recalling is “accurate” or whether others who were involved would share their perceptions. While this information might be important if one were working on a historical document, in TMS journaling, it is your feelings and perceptions that count! As a group, TMS patients generally tend to be more cognizant and protective of other people’s feelings in relation to their own. It often can be helpful to think of yourself as a small child, who views events only from his/her perspective and does not have to think about others’ feelings. For example, many TMS patients can find it difficult to get to feelings of anger toward their own parents because “they did the best they could.” This type of thinking is more of an adult or “rational” perspective and interferes in allowing one to experience painful emotions from childhood. Similarly, when writing about present day situations, it is imperative to write from your own perspective, and to not try to be judicious and represent various viewpoints. Remember, this is a journal about your feelings; you should NOT be thinking about giving a balanced account.
- One of the most frequent questions that patients ask me is about the “depth” of journaling that is helpful. Should they make lists, bullet points or write something that is more expansive? When I asked Dr. Sarno this question, he answered, “Patients need to go as far as they need to go.” In other words, if TMS symptoms subside after just making a list, you do not necessarily have to journal at a deeper level. However, if TMS symptoms persist, then it is important to journal on a more profound level. Writing in a more detailed manner may allow you to experience feelings (and by this I mean to actually feel angry or to feel sad or cry as you write). While bullet points may work for some people, if you continue to experience TMS symptoms, you might want to write with more detail. (For example, instead of “difficulties with boss,” you might want to write a narrative, “One day when my boss came into my office and I was sitting at my desk…and…”).
- It is important to keep the nuances in mind when journaling. It is often difficult for TMS patients to acknowledge having negative feelings toward someone that they love or with whom they are close. The journaling must explore the mixed feelings or nuances of the relationship. For example, loving a child, spouse or a parent, but simultaneously acknowledging what is difficult about the person.
- It is imperative that you do not write about pain or TMS symptoms. I have read patients’ journals that are filled with pages of being sad or angry about TMS symptoms. This will not only be unhelpful, but will serve to increase symptoms. Writing about pain is like thinking about TMS symptoms or focusing on pain. This is why your brain produced the symptoms in the first place – to distract you from your feelings! Journal entries should be about past or present situations that evoked strong feelings.
- It is often useful to journal about positive memories, too. Many patients believe that they only should journal about events, situations or people that made them sad or angry. However, another helpful strategy to experience your feelings through journaling is to think about fond memories. For example, I often ask patients in treatment to think about the “best” memory of their parent, sibling, spouse or friend. Or to write about what made spending time with someone so pleasant.
- Just like in treatment, another aim of journaling is to help the patient connect the present with the past. When journaling about present events, for example, it is important to think about what the current circumstances evoke for you emotionally. For example, when journaling about a difficult boss, to ask yourself, whether this person reminds you of anyone else in your life.
- I often advise patients to keep a little pad with them to jot down things in their daily life that either bring up feelings or that patients think should bring up feelings. Because it is the tendency for TMS patients to “sweep things under the carpet,” noting down emotional events (even seemingly inconsequential ones), can be a useful strategy to help patients keep their feelings in mind.
- Journal imperfectly! Journaling does not need to be in perfect sentences or in neat handwriting. If writing in fragments allows you to write down your memories and feelings as they occur, then this is indicated. Even though most patients know that this is an important part of TMS recovery, some patients never find the time for it. First you must ask yourself, whether this is another defensive strategy to distance yourself from feelings. If you truly do not have time or are not in a place where you can journal, then try to do the mental equivalent of journaling. Say the sentences in your mind that you would otherwise put on paper. It can be helpful to “free associate” as Freud would say. Try to write about a particular topic and just let the thoughts/ideas/feelings flow without trying to guide the writing in a particular direction.
- Dreams can be another source of journal material. Dreams often provide insight into unconscious sources of feeling, which is especially important for TMS patients, who might find it more challenging than the average person to recognize these sources of anger, sadness or other psychological conflicts.