Journaling Through Mental Illness: What Harms and What Heals (Remix)

Check Out BipolarShe.com to Register For Janine's Writing class. Starts September 13.

Enjoy this Summer Remix of Kathleen Adams' Episode "Journaling for Your Bipolar Brain."

Can journaling help your mental health—or sometimes make things worse? Journal therapy pioneer Kathleen Adams explains why unstructured free writing can become overwhelming for people dealing with trauma, dissociative disorders, depression, anxiety, mood disorders, or other intense emotional states. She shares how structure, pacing, and containment can make journaling safer and more useful, including techniques like sentence stems, brief sensory-based “captured moments,” reflection writing, and knowing when to stop. 

We also talk about what writing can look like during mania and depression, why “rage on the page” may help in some moments but deepen distress in others, and how to recognize when journaling is helping you process an experience versus pushing you further into it. Adams explains why writing does not have to be positive, polished, or even kept—and why tearing up a page can sometimes be part of the process. 

The episode also explores journal therapy, expressive writing, trauma recovery, dissociative identity disorder, bipolar disorder, depression, mania, emotional regulation, and neuroplasticity—with practical ideas for using writing as a mental health tool without simply writing yourself deeper into the pain.

Storytelling Class with Janine Begins September 13 on Zoom

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Transcript

Welcome And Safety Note

Janine 0:32

Welcome to Bipolar She. I'm your host, Janine Noel. The content of the show may include suicide or suicidal ideation. If you're ever in need of immediate support, please dial 988, a suicide and crisis lifeline. Before we get started, I am teaching a class called Writing Hard Stories, and this begins September 13th. I've led more than 50 writing workshops, and I continue because writing has been the lifeline for me. I've written in psych hospitals when I've been home recovering, and I've been immersed in good writing since getting my MFA. I incorporate some of the journaling techniques you'll hear about today, but my class is a broader creative writing course, focused on telling one good story. In my life, writing isn't just expression, but protection of my voice and yours. Today we revisit my interview with Kathleen Adams, who has been an innovator in the field of therapeutic writing. She is a psychotherapist, registered poetry journal therapist, and a master mentor and supervisor who got her start bringing her journal techniques into inpatient and intensive outpatient psychiatric programs. By 1988, she had founded the Center for Journal Therapy, and in 2008, Kay founded the Therapeutic Writing Institute, where I was lucky enough to get certified in leading her course,

Writing Hard Stories Class Invite

Janine 2:07

Journal to the Self, which is taught all over the world. Kay's mission is to share the power of writing with all who desired self-directed change, and she is author of 14 books on the power of writing.

SPEAKER_00 2:28

All right, welcome, Kay. Thank you, Janine. It's wonderful to be with you, and I'm so happy to welcome you into the family of certified instructors of Journal to the South.

Janine 2:40

I wanted to make sure listeners know that we do already have a relationship and that I have been through your training program. I'm so excited. It just came to me at a time where I was feeling really stuck. I had been doing writing, you know, creative writing and teaching it, but it just wasn't lighting me up anymore. And a friend recommended Journals to the Self to me. And I just felt the experience in that first two-hour class just transformative. And I just fell back in love with writing within two hours.

SPEAKER_00 3:13

So isn't it wonderful? Thank you.

Janine 3:17

It's such powerful work. It makes me think about your early work with the women who are on a psychiatric and the psych hospital and primarily

Meet Journal Therapy Pioneer Kathleen Adams

Janine 3:27

with disassociative disorder.

SPEAKER_00 3:30

Dissociative disorders. Yeah. Back in the day we called it multiple personality disorder. Now it's known as dissociative identity disorder. It is a result of almost always extreme trauma in early childhood. Not always, but that's the most common thing is severe abuse in childhood. And I've been working at a regular adult unit in a psychiatric hospital as the evening shift group counselor right out of graduate school for a few years. And then Journal to the Self came out during that time. This was Journal to the Self was published in 1990. And a psychiatrist in town who led this dissociative identity disorder program, apparently the book was quite popular. And so all of the patients had read Journal to the Self and they all loved it and they wanted a journal group started. The research psychologist in the field, Jamie Penebaker, James Pennerbaker, has a methodology of writing about stressful traumatic experiences that has formed the research base for almost everything we have in the field right now. And basically, one of the things he says is that when you are writing about traumatic or difficult material, it is normal to feel worse instead of better after you write, but it should resolve itself within a reasonable amount of time after you have a good night's sleep or eat dinner or take a shower or walk the dog. You know, just something distracting will shift you out of that mood in fairly short order. So I asked these patients, do you ever experience obstacles, blocks, or barriers as you are writing that ends up with you feeling worse instead of better,

When Free Writing Makes You Spiral

SPEAKER_00 5:12

and it doesn't resolve on its own. And 96% of them said yes. And I was floored by this. And so I started asking how they wrote, and almost without exception, they described a process that we call free writing, which is just sitting down and writing in your journal, you know, without much forethought of maybe you have a topic that you want to explore, but we don't really think about free writing as anything other than just writing in a journal. And my whole methodology is based on a lot of different ways to write in a journal, which I call techniques. And free writing is one of the techniques, but there's also 17 more. So I heard this story over and over about how they would, you know, kind of write themselves off the cliff and re-traumatize themselves as a result of trying to resolve their trauma. So when we got a little bit deeper in this, I realized free writing, by its very definition, has no structure, no pacing, no containment. You start where you start, you end when you end, there's no regulation other than your self-regulation. And they didn't have much experience with reliably being able to self-regulate. And I thought, well, if structure pacing and containment is completely absent here, what would be the most structured pasting contained thing that I can think of? I took all of my techniques, wrote them all out on three by five index cards, spread them out, gave them a relative structure pacing containment value, and then rearranged them in order. And it turns out that the most structured pasting contained technique that I teach is the sentence stem. Right now I feel, today I want, the most important thing to do, finish the sentence, you're done. Takes, you know, anywhere from a few seconds to a minute, maybe if you're writing a long sentence or more than one. And then I just, you know, anchored everything up as we went up the ladder and said to them, you know, if I could help you find a way to not fall off the cliff, would that be useful? And would you want that? They all said yes. So I taught them this method and they loved it. And they they didn't love every technique equally, which is normal, but they loved enough of them so that, and it didn't mean they didn't do free writing anymore, but when they started to feel tippy, they could back themselves down, bring in some structure, and stay on top of their own process. And it did teach them self-regulation and self-management skills because they could become aware of when it was starting to get too much and they could make their own intervention without going through the very difficult process of re-traumatizing.

Janine 8:06

I find this so interesting when we think about the bipolar community and how we have these nice lows, they can get quite low. And then we have the mania, which can be a bit uncomfortable or even psychosis. So there's so many different phases in this illness, particularly. I'm curious if you have advice for people with mood disorders.

SPEAKER_00 8:30

Yeah, I think the basic model, you know, at first I thought it was about trauma and it started out to be about trauma. But as I left hospital work and went into private practice a few years later, I realized that it's just a really basically good structure for all kinds of clinical cases. And that would include depression and anxiety and the cycles of bipolar illness. In our show preview, you talked about how you use writing. So when you're feeling manic, when you're feeling depressed, you just get it all down. And I think that's good. I think that's really, I mean, just a dump, a brain dump, is never really a bad thing unless it's kind of going south, in which case you can start to re-regulate. I think the big concerns that I talk to my clients about with depression and mania is that writing in a manic state can be a great way to just get it all out, but it can also become, and tell me if you ever experienced this, does it ever get overstimulating for you to be writing really fast in a manic state? Is that something that you encounter at all?

Janine 9:41

I don't know if I encountered that, but I have to say, I kept folders during some of these terrible times, hospitalizations. And I, you know, I have these crayon drawings and all different types of writing. And I also have some journals. And I look back and I go, okay. I must do this so this happens. I have to say this to that person. And

Sentence Stems For Containment

Janine 10:07

they're a little, they're unsettling to go back to and look at. So I don't know if in the act it was that difficult, but I couldn't even bring myself to look at them actually before our conversation.

SPEAKER_00 10:21

Yeah. Um, so sometimes it can be uh challenging to write at either end of the continuum. Depression, writing during a serious depressive episode can be problematic if there is no turn toward hope at any point in the right. So what I've always invited my clients with depression to do is to see if there's any little ray of light that can come in here. And we have a technique in Journal to the Self called Captured Moments, which is about taking any moment of intensity, of sensory intensity, whether it's positive or negative, and containing it in a very short right that focuses on sensory input. The paradoxical thing about captured moments seems to be that if you're writing about something really difficult, but you're doing it in a sensory-based way that doesn't take more than five to seven minutes, that can kind of hold and contain the experience. And if you're writing about a positive experience, a moment of beauty or a moment of grace or a moment of joy, and writing from that from the senses, it seems to expand. It seems to offer possibilities and hope, or at least relief, because we're writing about things that are beautiful or joyous or, you know, and that when done regularly, it contributes to an imprinting on the brain of how positive experiences are also valuable, and we can re-engage with them just as easily as we can re-engage with our stress or our fear or our dark moods or whatever it happens to be. So I really encourage anybody who is struggling with depression and writing to by all means, you know, pour it out and also be mindful of listening for in your words a place where you could reframe something into a more hopeful, positive, possible, you know, possibility thinking is really kind of what we're going for. Or whatever strengths support you in a time of a depressed mood. You know, people say writing it down makes it real. And a lot of people avoid writing because writing it down, they think makes it real. It doesn't make it real, it makes it known. You can write down all kinds of irrational thoughts, and they aren't real, but it brings to your awareness that you're having some potentially difficult distortions in your thinking.

Janine 13:09

I've heard this term rage on the page. And I think I have done that before. Yeah. Yeah. Everything's wrong with the world, and this is why. And actually, I think it was in your class, maybe one of the first exercises. We were supposed to think about a positive

Journaling Through Mania And Depression

Janine 13:27

relationship or something positive in our life. And I literally am like, there is nothing positive right now. Like, I can't do this exercise. I guess they sort of come from that position with journaling, that's a little bit more like rage. But by the end of your course, I really understood bringing in that light and how important it is, especially with this whole idea of neuroplasticity and how we're going to form new neural pathways through writing.

SPEAKER_00 13:57

Yeah, that's work that my colleague Deborah Ross has pioneered. Deborah was a student in my curriculum design class. She had been studying with Dan Siegel, who's one of the pioneers in neuroscience, specifically in positive brain change, neuroplasticity. And she did her curriculum design class on writing as a form of self-directed neuroplasticity. That was her theory. And she named her course Your Brain on Ink, which I thought was a brilliant title. So she has done just groundbreaking work in this and is a researcher at heart. And so she is up on all of the studies. And we wrote a book called Your Brain on Ink, and I always joke that she's the brains and I was the Ink. And she has some really beautiful theories and ideas about how writing in specific ways can really help you change your brain chemistry and your neuron firing and wiring to support neural pathways being developed. Over time, you can actually change the way that you think. And raging on the page, which is a term that I first heard from Deborah, I don't know if she coined it, but I first heard it from her. If you are just so mad you're going to pop, and you just hate everybody and everything in your life right now. And you know, we all have those moments, it's fine to just dump it all out. And the secret is remembering that if you're feeling worse instead of better and it's not resolving on its own in a reasonable amount of time, then maybe you need to shift it up a little bit and contain. But sometimes when you're raging on the page, the most effective thing to do is tear it out of your journal or print it out if you're writing digitally and tear it up or wad it up and stomp on it or do some intentional release and have that symbolize that you are releasing anger and hurt in a healthy, self-affirming way because you're externalizing it instead of internalizing it, and you're done with it now. You don't have to keep it around. So giving yourself permission, there's two other things besides structure pacing and containment. I later added balance

Captured Moments And Finding Light

SPEAKER_00 16:37

and permission. Structure pacing and containment, you can control those. You can say, I'm going to write for five minutes or I'm going to write for 10 minutes. Um, pacing, I'm going to go deep, and then I'm going to come up for air. And I'm going to walk around, get a drink of water, stretch, you know, check outside, see if the sun's shining, and come back to the writing. Structure is how you give yourself tools that will keep you from falling off the edge, like the structure of a specific technique, a readback of what you wrote, and then just dropping down a couple of lines in your journal and letting yourself reflect on it through a question or through a sentence stem that might start, as I read this, I notice, or I'm aware of, or I'm worried about, or I'm amazed by, or I'm curious, anything like that that just allows you to bring insight and awareness to what just happened. And I'd be curious to know what your experience of reflection rights is in the context of writing through either end of bipolar illness.

Janine 17:51

So I am a big fan of shredding. I have a shredding is a good thing right next to my desk, and that feels amazing. I think that the the reflection is still a little bit new to me. I think in the book Brain on Ink, I believe the point where you're reflecting and perhaps making changes in your life because of it, that's really when the neuroplasticity is setting in.

SPEAKER_00 18:22

Yeah. And it's practice, practice, practice. It's repetition. I would encourage you to think of this in terms of how you make new friendships or how you make new relationships. Because the the relationship with a journal is an actual ongoing relationship with yourself. So, you know, if you're tentative, if you're a little bit skeptical, if you don't feel like this is probably going to work for you, start small. Just write for five minutes about anything that's going on. It doesn't have to be important. It can just be, how's my day going so far? Or what's something I'm looking forward to? Or what's staying with me from yesterday that I'm still thinking about. And having a variety of ways to write is really helpful because it's not a one-size-fits-all thing. The reflection write can be one of the things that can help you realize in fairly short order that there may be more to it than just what is on the page. There's the feelings and the emotions and the ideas behind it that can all be captured in the reflection. And the reflection will also give you oftentimes a head start. As I read this, I'm aware that I want to explore this further. Well, there's a breadcrumb for you on the path. So pick another dimension of it and try it again the next day or whatever. There's no rules

Rage Writing Reflection And Permission

SPEAKER_00 19:42

other than the rules that you choose to put into place. And you don't have to write every day. You don't have to make sense. You don't have to write about positive things only. You don't have to do anything. This is a way of learning about your own preferences. And many times we don't really know what we prefer. We just do things because they're expected of us. And we don't always stop to think about is this really what I want to be doing? The journal is so flexible and so loving, is the word that comes to me, and so forgiving. You are driving this vehicle, and you can pull over on the side of the road anytime you want to. So I would say just give yourself permission to experiment, give yourself permission to try new things.

Janine 20:38

This work is just for anyone. It's enjoyable, challenging, but it's great for very successful writers that just want to reboot.

SPEAKER_00 20:48

Absolutely. Absolutely. And I just love the way that writing has really taken off in the field of mental health and emotional wellness because it's so useful. It's so helpful.

Janine 21:03

Well, thank you so much. It was just so nice to talk to you. I feel so fortunate to have gotten to know you, and I'm excited to do this journaling work. So thank you.

SPEAKER_00 21:15

Oh, I'm so thrilled, and thank you very much that you are such a gracious podcast host, and I appreciated the opportunity to talk with your audience.

Janine 21:27

Thank you so much for listening. We have a new feature in our podcast show notes. You can now text me at bipolar she. You can give me feedback, advice,

Text The Host Rate Review Share

Janine 21:37

any stories that you would like to hear, any stories that you would like to tell, please let me know. And if you can, please rate and review us. A single sentence about this show is so meaningful. And as always, sharing a podcast with someone who needs it matters the most. Thanks.