Pain Awareness Through Journaling, and Using It to Manage Chronic Pain

The importance of journaling is mostly underrated. Learn more about journaling and how it can be used to assist in managing chronic pain.

What is Journaling?

Journaling is one method you can use to take stock of your thoughts and feelings. This usually comes with the intention of working through them in a positive direction. Like meditation, it is a mindfulness-oriented intervention. When used correctly, it can be a therapeutic treatment that fosters awareness and acceptance.
Mental health professionals sometimes use journaling to help patients cope with and work through issues such as:

  • Chronic Pain
  • Stress
  • Depression
  • Anxiety
  • To create self-awareness
  • To establish personal values
  • To exercise imagination

The Types of Journals You Can Keep

There are many different types of journals you can keep, with some common ones being:

  • Gratitude journal
  • Medication log
  • Mood tracker
  • Habits tracker
  • Exercise log
  • Daily dairy

There are also many different styles of journaling you can use to keep track of all this data. Bullet journaling is popular for its practicality, creativity, and most importantly, its flexibility. If you do not like starting a journal from scratch, there are also many ready-made options for sale. Whilst these may confine your entries, they will also save you time and effort. There are many beautiful and functional journal apps you can download if you prefer, too. Setting a journal up may be therapeutic to some, but stressful to others. Do what works for you.

The kind of journal(s) and methods we will focus on in this article will all be related to pain and managing it.

The Benefits of Writing by Hand

There are many mental and emotional benefits when you write by hand. The act of writing every alphabet stroke by stroke involves pathways in the brain which go near or past areas that manage emotions. It also forces us to slow down, pay more attention to our thoughts, and how we want to communicate them to others.

Getting Started with Your Pain Journal

There are many kinds of paper used in books, and they also come in a variety of sizes and page styles: blank, lined, dotted, etc. Choose one that meets your needs and creativity style – do you want to draw all over it, or write neat lines of text? Paper quality matters, if you’re going to use watercolour or calligraphy inks on them. Note that these are just to enhance the journaling experience. It doesn’t matter if you don’t have them at your disposal – a simple notebook can work just as well. The most important thing is to get started, adapt it to your needs, and then use the data to improve your quality of life.

Things to List Down in Your Pain Journal

Chronic pain and illnesses are so rare and unique, and their symptoms inexhaustible. Even people living with the same illness can have totally different experiences. Here are some suggestions of things you can record in your pain journal:

  • Basic Data for Reference. Medications and vitamins you are currently taking, their dosages, times you take them, etc. The drug brand can also matter for some people.
  • Vitals. What’s important in relation to your condition. Blood pressure, temperature, blood sugar, blood clotting ratio, etc.
  • Where is the Pain Located? Which parts of your body do they affect, and how does it make you feel?
  • What Does the Pain Feel Like? Is it burning, aching, pounding, throbbing? Is it always there, or comes and goes, and to what frequency? Or perhaps it isn’t so much pain in and of itself, but more of itching, tingling, or some other uncomfortable sensation?
  • When Does it Hurt? Is it worse in the morning or at night? What about in a certain environment, situation or position? Does it only hurt days after an activity, instead of immediately?
  • What Triggers the Pain? Does a change in weather or humidity levels make a difference? Perhaps air or car travel? What about walking your dog or doing certain household chores? Stress from work, parenting, or caregiving? Changes in hormonal levels during a certain period in your menstrual cycle?
  • How Bad is the Pain? You can use a scale of 0 – 10, or whatever range you prefer, and leave some space for notes or a description. You can choose to draw diagrams or charts instead of using numbers, if you feel it best represents your pain. It is important to quantify or visualise it in a way that patterns can be drawn from eventually, however. This is so you can make clear correlations for positive changes.
  • Food and Water Log. What foods do you put into your body every day, and how much water do you drink? Many people do not even realise that they’re sensitive to certain foods or that they’re dehydrated.
  • Sleep Tracker. How much sleep are you getting per night, and how much of it is quality sleep? How often do you wake up at night and why? Is it due to pain, itching, nightmares, or to use the bathroom? How much worse or different is the pain at night as compared to other times of the day?
  • Mood Tracker. Physical pain goes hand in hand with mental and emotional health. Nothing in our body is standalone. You can track it in a similar fashion as ‘how bad is the pain’.
  • Comments Area. Scribble down your thoughts, research you want to do, questions for your doctor, quotes that inspire you, etc.

These are merely suggestions. You can of course, modify or add whatever other data you think relates to your health, and is important to track.

Ways to Collect and Quantify Your Health Data

Over time, you should start to link patterns and see correlations with your pain and its causes. More often than not it isn’t due to only one thing, but a combination of both external and internal factors. A chain reaction of causes and effects. Here’s a step-by-step guide you can use, if you don’t know where to start:

  • Decide what you want to track, and how. This data should be quantifiable, but feel free to give room for notes, thoughts and comments.
  • Traditional Graphs. You can draw up a graph that will help you to connect the dots on a weekly or monthly basis. See where it peaks and falls, and if there is a common cause behind them.
  • Calendars. You can also use a monthly or weekly calendar. Colours are very useful for instant feedback and visualisation, too.

How to Use This Data to Manage your Pain

Sometimes it can be hard to see the negative patterns in the first place, because it’s become habitual and routine to us. Nothing seems out of the norm. Recording it in a journal can help us to put some distance between them, so that we can see things from a wider perspective. We can then use this information to make purposeful changes in our lives. Take note of what works best, and refer to them from time to time.

Apart from reflecting on your routines, you can also use your journal to set new goals and to form good habits. Neuroplasticity is a good method to reduce chronic pain over time. It works by forming new pathways in the brain through habitual practice. Journaling is a good tool to complement this mindful exercise, as you think about it and inch towards your goals every day.

Integrate Expressive Writing for Better Results

Expressive writing, at its core, is about paying full attention to our emotions and how we feel about things. Pay no heed to proper usage of grammar, spelling, punctuation, etc or being ‘correct’. It doesn’t even matter if you can’t write – you can verbalise it through an audio recording, or similar. In a research by psychologist Dr. Hans Schroder, he shows that expressive writing helps to free up brain space, which in turn allows our brain to function more efficiently.
Pioneered by Dr. James Pennebaker, Chair of Psychology at the University of Texas, his research of over 300 studies have shown the numerous potential benefits of expressive writing, such as:

  • Reduction of chronic pain, fatigue and tension
  • Positive influence on the immune system
  • Boost in thinking ability
  • Improvement in working memory
  • Enhancement of mood 
  • Improvement in sleep quality

Journaling in and of itself can become harmful, if we don’t use it to manage pain in a correct way. If all we do is whine in it, this reinforces negative thoughts and feelings, with no aim or plan of action. What we need to do is work towards positive change instead, by putting things into perspective. Expressive writing doesn’t occupy much time, but can have huge benefits on your wellbeing.

How to Use Expressive Writing in Your Journal

The process of expressive writing is fairly straightforward, although the topics you deal with might not be easy. Full instructions and more information can be found here, but here’s how to use this method in brief:

  1. Write without stopping. Let the words flow. Ignore all flaws and mistakes. If you run out of things to say, draw a line or repeat what you have already written. Just keep writing.
  2. Write only for yourself. No one else is going to see this, so feel free to express your innermost thoughts.
  3. Observe the Flip-Out Rule. If a certain event starts to traumatise you so much such that you cannot write on, stop for now.
  4. Expect negative emotions. It is normal to feel down when you first begin to write in this narrative format. Don’t worry, these feelings should recede over time.
  5. Return to reflect upon what you have written after four days. View it from different perspectives, and decide on how you want to act or behave next.

Once I recovered from pain, I decided to dedicate my time to creating a product to help others in the same situation as me. Needlessly suffering from real, ongoing and disabling pain, when all other treatments fail.

How Pathways Can Help with Your Pain Management Journey

Pathways is an app (update Aug 2023: Pathways is now a web app! Start our program here) that uses the power of neuroplasticity to help its users cope with and reduce chronic pain. The techniques are based on science, and the web app comes with a good knowledge database, exercises and step-by-step guide. You can use the knowledge you gain from the app (update Aug 2023: Pathways is now a web app! Start our program here), and apply them to your journaling practice, too.we wish you all the best in your pain recovery journey!

Please note: This article is made available for educational purposes only, not to provide personal medical advice.

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