A Science-Supported Journaling Protocol to Improve Mental & Physical Health

Andrew Huberman, who introduces himself as a professor of neurobiology and ophthalmology at Stanford School of Medicine, opens by narrowing the subject. The episode is not about the general value of journaling. It covers one specific method that, he says, is supported by over 200 peer-reviewed studies in quality journals. He admits he did not know about the practice before researching the episode. After that research, he argues it belongs among the foundational practices for mental and physical health.

The benefits he lists are broad. They include lower anxiety, better sleep, and improved immunity to things like colds and flus. He also cites reduced symptoms of autoimmune disorders such as arthritis and lupus, and some relief for fibromyalgia, which he describes as a condition of excessive pain. He adds improvements in everyday measures such as memory and decision-making. In this opening section these outcomes are stated as summaries of the literature. The individual studies, sample sizes and effect sizes behind each claim are not given here.

He also addresses an obvious question: if the method is this powerful, why isn't it widely known? His answer is that it has been "somewhat cloistered within the fields of psychology and psychiatry." He first heard of it from Dr. David Spiegel, associate chair of psychiatry at Stanford University School of Medicine and a past guest on the podcast. He then read the primary research himself.

Much of the method's appeal is how little time it takes. It can be done within one week or across one month and then never repeated. According to the host, the data say the benefits for body and mind still last. He says he is spending a full episode on it because the details matter if people want the protocol to work as well as possible. He also notes that the podcast is separate from his teaching and research roles at Stanford.

The protocol traces to Dr. James Pennebaker. He began the research as a professor of psychology at Southern Methodist University and later moved to the University of Texas, Austin. There he still runs a laboratory studying how spoken and written language affect mental and physical health. The research began in the mid-1980s, and the first manuscript on this form of journaling was published in 1986.

The host is careful about who gets credit. Others had used similar writing before Pennebaker. What Pennebaker contributed was measuring the specific changes people underwent and settling on a precise protocol. According to the host, Pennebaker worked out how long the method should be carried out and what changes occurred in body and mind. He tested it with students, the general population, veterans, elderly people and children. The host credits this rigor for the protocol's strength.

In the 1986 study, undergraduates came into the laboratory one at a time. Each spent 15 to 30 minutes writing about the most difficult experience they could recall from their entire life, whether or not it was traumatic. The rules had three main parts. First, participants chose that most difficult experience. Second, they wrote for 15 to 30 minutes. Third, they wrote without stopping for the whole time, unless they became emotionally or physically unable to continue. Because the writing was done by hand, this meant never lifting the hand from the page.

Privacy and freedom from form were part of the design. Nobody else would see the writing at any point, and students could tear up the paper afterward if they wanted. They were told to ignore grammar, readability and spelling. What mattered was reaching a "particularly negatively charged memory" from their past.

The host reads from the instructions used in the first study, which he says were reused across the later literature. Participants were told to:

Write about something that you are thinking about or worrying about way too much.

He widens the possible topics. They include something a person has deliberately tried not to think about, something that shows up in disturbing dreams, or something affecting life in an unhealthy way. That could look like an inability to calm down, rumination, compulsive thought, or addictive, compulsive or habitual behavior. A specific trauma or set of traumas also qualifies. The core instruction he passes on to listeners is:

I want you to write down your deepest emotions and thoughts as they relate to the most upsetting experience in your life. Really let go and explore your feelings and thoughts about it.

The instructions suggest linking the experience to childhood, parents or siblings, past or current loved ones, career or schooling. They also ask how the experience relates to who the writer has been, who they are now and who they would like to become. For people without a truly traumatic experience, the instructions point out that everyone has had major conflicts or stressors. Those people can write about the most dramatic or stressful experience they have had.

The laboratory gave participants a quiet place to write undisturbed. The host stresses that anyone trying this at home needs a place where they won't be interrupted for the whole 15 to 30 minutes. The original study used pen or pencil and paper. According to him, later studies tested whether handwriting mattered and found it does not. The same magnitude of positive effects appeared whether people wrote by hand, typed on a word processor or used another form of writing.

The range of 15 to 30 minutes reflects differences between experiments, which used 30-, 20- or 15-minute periods. The host reports no major differences in benefit between the 15- and 30-minute blocks. He adds a practical point: for some experiences, 15 minutes may be too short to capture everything. People can allow up to 30 minutes and stop early, or keep to 15 minutes and push themselves to get out as much as possible. "It really doesn't matter, or so say the data." Participants also got a few minutes beforehand to decide what to write about.

The host separates the protocol from three familiar practices. The first is morning notes: stream-of-consciousness writing for 5 to 30 minutes each morning, which writers use to "clear out the clutter." The second is gratitude journaling, which he calls "quite the opposite" of this protocol. This method is about very unfortunate events that carry charged negative emotions, not about things a person is grateful for. The third is the autobiographical diary that records daily life.

He uses his own journals to illustrate the third type. He has stacks of composition notebooks going back to the early 1990s, all written by hand, including entries from 1992, fall 1996 and summer 1997. Rereading them, he found they were mostly updates on recent events, hopes and challenges, basically a diary. The rereading brought a few cringe moments and some smiles at how little, and also how much, he had changed. His point is that this kind of journaling is "far and away different" from the protocol discussed in the episode.

He does not dismiss the other forms. He says there are data showing that gratitude journaling in particular can benefit body and mind, from general happiness to reduced anxiety and better relationships. His claim is that the trauma- or stressor-focused protocol is a separate tool, not that the others are useless.

The host is frank that the protocol is "not likely to feel very good, at least not at first," and says the research shows this. During the sessions, participants were often quite distraught. They often cried or held their breath in anxiety, and they could finish feeling as if they had run a mental marathon. For that reason, the studies gave participants 5 to 15 minutes after writing to settle down before going back to their day.