Along with my intro to CBT blog, I want to also start a number of blogs around various techniques involved in the work of a cognitive behavioural therapist and what one might see as outcomes and how they can help facilitate change in a person. For this first one, we will have a look at journaling and how we might use it within therapy and outside to help people come to a better understanding of what is happening and why.
Growing up, my parents would have recommended to me at various times to keep a diary or write things down. I remember this same thing being said in primary school and see it being recommended in today’s world now more than ever to people. As a CBT therapist, I can be very clinical when it comes to new ideas or techniques to be used for people and in general for my own life. I want to know how it works, why it works and how the get the best benefit out of it. These are the questions I will answer in relation to journaling from a CBT perspective and hopefully give some more insight into why it is one of the most common techniques used in CBT and therapy in general.
How does it work?
From a very basic standpoint it is simply writing down what happened in your day, your past or what you want from the future. From a non CBT perspective, keeping a journal or diary seems quite simple. When we journal from a CBT perspective, it changes up the way we record our life. (There are various methods of journaling within CBT but I will stick with the one I use most with clients).
The diary or journal is broken into four headings for each entry:
- What happened? (Situation/Event)
- What did I think? (Thoughts)
- What did I feel? (Emotions)
- What did I do? (Behaviour)
If you have read one of my previous blogs, this will sound similar to how I describe CBT. The way this works is to break down what happened into various headings to categorise, this will be explained in the next question (Why does it work? Further down). There is no right or wrong way to keep a journal as long as you are following these headings to the best you can. At first, I find a lot of clients might struggle to remember what they thought or what the emotion was, but in time this awareness comes as you spend more time recording what happened.
An example entry might be:
1. What happened? – I received my exam results and I have failed
2. What did I think? – I am a failure, how could I fail, what did I do wrong, I can never pass this, my life is over
3. What did I feel? – Shock, Anger, Sadness, Resentment
4. What did I do? – I cried for a while and then ignored it and went hanging out with friends
Why does journaling work?
The goal of journaling from a CBT perspective can be broken down into three goals.
The first is to start building that awareness of what is happening in your life by breaking it down into headings that help better understand why you did what you did and how you did what you did. This awareness might start out low as I mentioned above that a lot of clients might not easily establish or recognise what thoughts they were having or emotions. This awareness is starting to be built and a trick I give clients is: As something impactful/stressful/sad is happening in your life and it can be something tiny, just ask the question to yourself “What is going on for me right now?” in particular attention to the thoughts. This awareness building will stand to you in all areas of life far after therapy has finished.
The second outcome of journaling is that we are now starting to view life and the events that happen in our life in this CBT mind-set, what happened, what I thought, what I felt and what I did. The reason for this is that it can feel like we jump to anxiety/anger/sadness too quick without understanding what actually happened to bring us to these intense feelings. This mind-set, the very same as above will stand to you long after therapy has finished.
The third and final outcome is change. Now that we have been building that awareness over time and starting to look at the world in this way, it is now time to change what we want to change. Taking anger as an example, there will normally be a pattern of thoughts that are very similar each time the anger flares up. The very same could be for the situation or event. Similar things seem to trigger the anger. With this in mind, we can start challenging the thoughts that are coming up right before the anger kicks in and look to change the way the anger plays out. I could write a whole book on this alone and I hope I am explaining it properly in this short way. This change is fuelled by the first two outcomes and cannot happen without the first two. We need that awareness and we need that understanding to help us change the way we are reacting. This is the very same with Anxiety, Depression, OCD, etc etc.
For the next blog, I will go into detail about how we can best maintain journaling and get the most benefit out of it so stay tuned. Hopefully I have given a good insight into how journaling could go and what to expect from it. If you have any questions or query’s please feel free to contact me at: Patrick@evolvementalhealth.ie or our team at: info@evolvementalhealth.ie where we would be happy to answer anything we can.
Stay tuned for when we look at some of the techniques used from a cognitive and behavioural perspective.