Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.
Are you keeping a healthcare journal?
It seems like a lot of other members are. I am also hearing from doctors who are recommending their patients keep journals. I’ve even recommended journaling to a few of my clients.
I have to admit that when I first heard of healthcare journals, I couldn’t help but think back to fifth grade. That was the year our teacher gave us each the assignment of maintaining a diary. She told us to write in it every day.
I tried, I really did. But I never knew what to write. So when we finally had to bring them into school and show her what we had come up with, I was pretty ashamed of mine. It basically consisted of “Went to school today” from Monday through Friday. I took weekends off.
I suspect mine was used as the example of what a lazy diarist is. It probably got a few laughs in the teacher’s lounge.
But I have, over the years, figured out that a journal doesn’t have to require the long, meandering reflections on life we normally associate with diaries. In fact, a journal can be a really useful tool for a lot of purposes.
I encourage journaling for clients who are going through life transitions, like coping with a medical diagnosis, for example, or recovering from a loss. It’s a way to get all those thoughts and feelings out that they might not feel ready to express to anyone else. Sometimes they bring their journals in and we talk about what they wrote. And sometimes not.
And for clients living with diabetes or other chronic conditions, a journal can be a great place to record symptoms, thoughts, and questions. It can also help them in communicating with their healthcare providers and using their appointment time more efficiently.
Interested? Here are some ideas about how to make the most of your journal:
1. Choose a medium that works for you. If you’re comfortable writing on your computer screen, then create a document for each journal entry, or create one document and keep adding to it. If you would rather write on paper, then get a notebook in a size that is comfortable for you and do your writing there.
2. Maintain your privacy. You will feel a whole lot freer to write in your journal if you can keep it private. So if you share a computer with someone else, you may want to find a way to keep your journal separate from the other users. If your journal is in a notebook, keep it in a place that will protect it from wandering eyes. Unless you want to share it, that is.
3. Vent. Sit down in a quiet place and let yourself free-write for a few minutes. Don’t censor yourself, don’t second-guess. Just let it out. What’s on paper will no longer have to be bouncing around in your mind. Remember you are only writing this for yourself.
4. Track. Your journal is a great place to record what’s going on with your physical and mental health. Record symptoms that you are experiencing. Get specific, including the kinds of symptoms, the severity, and the duration. Record the time of day and what you might have been doing at the time. Make sure you have the correct date. You should also record any medications you were taking. If there is anything your healthcare provider has asked you to watch for, make sure you include that as well.
5. Make note of the good and the not so good. Your journal doesn’t have to be all about what’s going badly in your life. Turn off that inner voice of judgment. Write about what makes you feel worse and what makes you feel better. By the way, be honest. For example, if you have slipped up on your self-care regimen in some way, record that as well.
6.Record questions. As you write in your journal, questions might pop up. Most likely, these are the kinds of questions you wish you had remembered to ask your doctor but probably didn’t. Just to make sure they don’t get lost, here are a couple of ideas: You can highlight the questions by underlining them or typing them in bold. Or you can keep a separate list of questions. Either way, make sure your questions are easily accessible so you can bring them to your next appointment.
7. Gather evidence. Think of yourself as preparing to make a case by gathering lots of evidence. This might be a case that you present to yourself to motivate yourself to make changes in your life. Or a case that you will present to your healthcare provider to help the two of you make decisions together. The more evidence you have, and the more specific it is, the stronger your case.
8. Look for themes. Go back over what you have written in your journal. See if any themes jump out at you. These themes might be physical; feeling a certain way in the morning or at night; symptoms that arise when you take a specific medication or a number of medications at the same time; or foods that seem to leave you feeling a certain way. Or your themes might be emotional: someone in your life who has a way of saying something that ruins your day, or that makes your day better; an activity that tends to leave you feeling depleted or that picks you up; or states of mind that lead to productive or unproductive behaviors. You might talk about these themes with your healthcare team.
9. Bring the highlights to your next appointment. You can print out pages to bring to your appointment, bring in your notebook, or make a few notes to bring in. While your healthcare provider won’t have time to go through it page by page, he/she might appreciate that you can quickly present any highlights that you think are important and that you’re ready to provide any additional information that might be needed. Having your questions along can also help you make better use of the time you and your healthcare provider have together. And again, you’ll be less likely to forget what you intended to talk about.
10. Keeping a healthcare journal doesn’t have to be hard work. The harder you make it, the less likely you will be to follow through. Don’t force yourself to write in it every day. Don’t worry about perfect grammar and paragraph structure. Make your journal what you want it to be. For tracking. Recording your thoughts and feelings. For storing up questions. Decide what purpose you want your journal to serve and work it into your routine.
You and your healthcare journal. It’s not a classroom assignment. It’s for you and you alone. Enjoy the process and reap the benefits!
More from Dr. Gary:
You and Your Relationships: A Positive Perspective on Negative People
When the Diagnosis Is Terminal. Eleven Steps Toward Coping … and Hope
Talking to Your Doctor: Deciding When, How – and If – to Speak Up