Note by Dr Suraj Manjunath: Cancer patients and their families go through a tremendous amount of mental strain and anxiety at the time of diagnosis, during treatment as well as in the follow-up period. Many of them develop their own unique mechanisms of coping. In my clinical practice, a number of patients have reported that “maintaining a diary” or “journaling” has worked for them as an effective coping strategy. This article by Haripriya Suraj gives an insight into this particular practice and its potential uses for people dealing with cancer.

Cancer is a complex illness that challenges patients in varied ways. The often prolonged course of treatment can be stressful to both body and mind. It is perfectly normal for patients to have several questions and also to experience a plethora of difficult emotions as they undergo treatment. While it is important to have support from the core medical team as well as family and friends, knowing additional ways to cope can help bring more ease to the journey.

“Journaling” is a practice that involves the consistent expression of one’s thoughts, feelings, and emotions on paper (or screen).

There is a good amount of research work^1,2 showing evidence that the practice of journaling (either manual writing or online) helps people with different illnesses reduce mental distress and improve well-being, including some research on patients with cancer.³

Potential Benefits of Journaling In Cancer Care:

1. Processing Of Complex Negative Emotions – Negative emotions (like fear or anger) when left unchecked, can take on a life of their own and begin to feel overbearing. However, when they are expressed, they lose some of their intensity. It may not always be easy to talk to other people about how one is feeling. However, a journal is a safe space for free expression. Putting down one’s feelings on paper can help reduce the charge of a negative emotion, making the way for lightness and new perspectives to emerge.
2. Reflection & Communication – Journaling is a great way to reflect on how a day went for a patient. Writing can help them clearly recognize how they are feeling at a given point in time and also help them convey their messages more effectively to their doctor and caregivers.
3. Development of a Positive Outlook – As one writes, a story is woven. Every story is likely to have some positive aspects too. While it is easy for a patient to see herself or himself as a powerless victim of circumstances, the story can also help them recognize some of their hidden strengths. It can bring to their awareness many things that are working well for them and help foster a sense of gratitude. This can give them the encouragement and resilience needed to stay the course.

To summarize, journaling is a simple, inexpensive, and easy tool that can be used as a way to improve mental well-being for people facing challenging situations, including illnesses like cancer.

References:

1. Smyth, J. M., Johnson, J. A., Auer, B. J., Lehman, E., Talamo, G., & Sciamanna, C. N. (2018). Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial. JMIR mental health, 5(4), e11290. https://doi.org/10.2196/11290
2. Ullrich, P.M., Lutgendorf, S.K. Journaling about stressful events: Effects of cognitive processing and emotional expression. behav. med. 24, 244–250 (2002). https://doi.org/10.1207/S15324796ABM2403_10
3. Smith, S., Anderson-Hanley, C., Langrock, A., & Compas, B. (2005). The effects of journaling for women with newly diagnosed breast cancer. Psycho-oncology, 14(12), 1075–1082. https://doi.org/10.1002/pon.912