That was true for Lisa Shulman, MD, FAAN, professor of neurology at the University of Maryland, editor-in-chief of the American Academy of Neurology's Brain & Life Books^® series, and a member of the Brain & Life editorial board. After her husband, Bill Weiner, who was also a neurologist, was diagnosed with cancer and died 18 months later, she felt uncertain about her identity and her future. In the years following this loss, she wrote Before and After Loss: A Neurologist's Perspective on Loss, Grief, and Our Brain (Johns Hopkins University Press, 2018), a book about her experience. One of the crucial components of her healing was journaling. Here, she explains how journaling was beneficial for her, and how to start your own journal.

When did you first start writing in a journal?

In the days just after Bill’s diagnosis, he and I agreed to each keep a journal. My own journal became the basis of my book, but we never shared our journals with each other. After Bill died, I couldn’t bring myself to look at his journal for a long time. When I finally did, I included passages from it in the book.

What led you back to journaling?

For months, I didn’t derive comfort from the usual antidotes to grief such as attending a support group or talking to a counselor. They didn’t represent a way forward for me. Then, one day when I was overwhelmed and agitated, I felt the urge to sit down and try to crystallize my thoughts on paper. And for the first time, I felt a lessening of my distress. It was very powerful. I knew right away this was the tool I needed.

Can you describe the power of journaling?

It wasn’t just effective for getting things off my chest. It was also meditative and allowed me to get at the heart of what I was so distressed about. It was also extremely helpful to read my own words about what was happening. So often when we experience emotional trauma the enormity of it is overwhelming. Giving it a concrete description causes it to feel more manageable. And taking the time to put my emotions into words helped me get in touch with and identify the distress I was feeling.

Can you explain how journaling helps process grief?

In my case, it wasn’t enough to write about the events surrounding my husband’s illness and death. I had to drill deep inside myself and ask, “What is the meaning of this loss to me? What are the different facets of how it affects the way I perceive my identity, my life, my future? What components of it are so distressing?” It’s very hard to look in the mirror and be honest and genuine with yourself. Journaling helped me do that. Reading and rereading my attempts to describe what was causing such turmoil in my mind allowed me to give voice and shape to that feeling.

How was rereading entries from the time of Bill’s death helpful?

Our minds play tricks on us, and we can easily forget the time frame and sequence of events. Or forget things entirely. Because Bill’s death was so difficult and pivotal, I don’t tire of rereading the sections about it. It is continuously therapeutic, allowing me to revisit a painful period but with the perspective of how life has unfolded. Conventional wisdom tells us to avoid reliving painful events but rereading these sections in my journal helps me grow and gain insight.

How did journaling help you manage stress?

Journaling helps short-circuit the chronic stress following traumatic events. Reconnecting and becoming more comfortable with suppressed memories calms the fear center of the brain, which is on overdrive during the grieving process. For me, each time I reread a distressing memory, I annotated it with more information and a revised response from a new perspective. The repetition of writing, reading, and re-reading gradually helped me fit these disturbing memories into my life story.

In what way did journaling help you grow and heal?

My entries became a kind of therapy. I looked for meaning in the words I chose and the themes I described. Sometimes I remembered something I had totally neglected in telling the story. I would ask myself, “Why did I emphasize this and neglect that? Why did I leave out this whole part?” Each of these steps was a formative step toward healing and emotional restoration. At some point, what had been overwhelming became part of my life story.

How to start your own journal

After finding success with journaling to help with her own grief, Dr. Shulman offers tips on how you can get started with journaling.

What’s one of the first steps in starting a journal?

It’s important to establish your own ritual, your own way of journaling that works for you. Don’t feel you have to conform to any particular style. Experiment to find out what’s going to work and be successful for you.

What else is conducive to journaling?

Determine the best time of day to journal. We all have our own biorhythms; you will find that certain hours of the day are more amenable to this type of therapeutic work. Create a space for journaling whether that’s in your favorite chair, your study, in front of your fireplace, or in your kitchen. Decide if you want to use a computer or a pen and paper. Once you’ve figured these things out, then try to journal in the same way and place every time. After a while, as soon as you get into that comfy easy chair, it’s almost like your mind is poised to get busy journaling. It’s almost automatic.

Is the style of writing important?

You need to find your own style, but many people recommend putting pen to paper and not picking it up again, to just keep writing and let the words flow. That keeps you from editing yourself. If you’re always editing, you won’t get very far. Once you’ve written as much as you can, you can go back and edit and annotate. That itself is therapeutic. Over time, you’ll identify important features of your story or feelings, and you’ll be inspired to write more about them.

How do you make journaling meaningful?

Use journaling to get in touch with thoughts, memories, and emotions buried deep within you. Sometimes you may find that you’re writing around a topic that you can’t grasp. It’s so disturbing you can’t quite put your finger on it. That’s because these difficult memories are being suppressed. Writing and then reading it over helps you get to it. Often the most therapeutic benefit of journaling is returning over and over to previous entries. With each review, you will find yourself annotating your own words based on new revelations and perspectives.

Who should you write for?

You’re writing a journal only for yourself, and that’s what’s freeing about it. You don’t have to filter anything. It’s an opportunity to drill down and be honest with yourself, which at times can be painful, but also very healing. The key is to be as raw, genuine, and authentic as possible.

Can you give an example of how journaling can be healing?

Let’s consider a neurologic diagnosis, whether it’s your own or a loved one’s. Immediately after, you might just keep a basic chronology of events and describe your immediate reactions to these events. Later, you can interpret those events through the passage of time. You might write about the impact the diagnosis has on your life and relationships. You might describe the challenges and tensions you’re feeling. A diagnosis can make you feel vulnerable and diminished. You might write about how you want to maintain your independence and strength and personhood as you undergo treatment. If you’re a caregiver, you might write about the tension between being supportive, even overprotective, but still finding time for yourself. Or you may describe your concerns about how the disease may alter your relationship. Journaling is an opportunity to write down and face your fears. If you’re experiencing a life-changing illness, it’s healthier to state your fears than to suppress them.

How does journaling contribute to growth after loss?

With practice, you learn to be more and more honest with yourself. We all have self-deceptions to some extent, but journaling helps push through that. And with each successive entry and greater distance from traumatic events, you can track your progress and growth. As you compare earlier entries with later ones, you’ll see, in black and white, your path toward healing.