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

Key Takeaways

Discover Dr. Huberman's transformative journaling method for holistic health, backed by scientific studies. Segment 01
Dr. Pennebaker's journaling method explores deep emotions, childhood connections, and adaptability. Segment 3
Dr. Huberman emphasizes an intensive journaling method, confronting challenging experiences for transformative learning. Segment 05
Dr. Huberman explores the impact of language on emotions, linking it to transformative journaling. Segment 07
Dr. Huberman unveils enduring positive changes in mental and physical health through transformative journaling. Segment 09
The expressive writing protocol advantages neuroplasticity by reshaping neural networks and fostering lasting mental and physical health improvements. Segment 11
The expressive writing protocol counters trauma's impact by enhancing narrative coherence and triggering neuroplasticity, fostering relief and understanding. Segment 13
Recent studies reveal positive shifts in health and immune function through expressive writing's neuroplasticity-inducing impact on the prefrontal cortex. Segment 15

Summary

In the forthcoming episode, Dr. Andrew Huberman will elucidate a particular writing procedure that has been substantiated by numerous scientific studies to yield substantial enhancements in both immediate and long-term health outcomes. The individual in question will provide a comprehensive explanation of the implementation of the aforementioned protocol, which may be completed within a time frame of four days with a time commitment of 15–30 minutes per day. The presenter will additionally elucidate the process by which the four-day writing program influences neuroplasticity, resulting in alterations in brain rewiring and function over both immediate and extended periods. The speaker will elucidate the ways in which these alterations in the brain have a beneficial effect on our physical well-being, encompassing enhancements in our immune system's functionality and bolstering our capacity to combat infections. Additionally, these changes contribute to improved sleep patterns, diminished sensations of physical and mental distress, reduced anxiety levels, and facilitate the process of healing from traumatic experiences. This particular episode is likely to capture the attention of individuals who are interested in enhancing their mental and/or physical well-being by employing concise yet scientifically validated techniques.

(01). 00:00:00 Journaling Protocol for Mental & Physical Health

Dr. Andrew Huberman introduces a journaling method supported by over 200 peer-reviewed studies, positioning it as a foundational practice for improving mental and physical health. Despite its powerful impact on lowering anxiety, enhancing sleep, boosting immunity, and alleviating symptoms of autoimmune disorders, this particular journaling method has been somewhat hidden within the realms of psychology and psychiatry. Dr. Huberman learned about it from Dr. David Spiegel, the associate chair of psychiatry at Stanford University School of Medicine. The method, which requires a relatively small time investment over one week or month, promises lasting positive benefits for both body and mind. The podcast delves into the specific protocol, highlighting essential details for effective implementation, and explores the underlying scientific explanations for its effectiveness in improving various aspects of everyday living, such as memory and decision-making [1].

References

1. Kazmi, S.M.A., et al., Mental and physical health correlates of the psychological impact of the first wave of COVID-19 among general population of Pakistan. 2022. 13.

(02). 00:07:16 Journaling & Confronting Traumatic Events

Dr. James Pennebaker, initially a psychology professor at Southern Methodist University and now at the University of Texas at Austin, conducted transformative research on a specific form of journaling that has proven to positively impact both mental and physical health. Originating in the mid-80s, the first published manuscript on this method emerged in 1986, attributing Pennebaker's ability to attach precise measurements to the changes observed during this unique journaling practice. The protocol involves individuals spending 15 to 30 minutes writing about the most challenging, potentially traumatic experiences from their lives, with the crucial instruction to write continuously without pause. The emphasis is on the emotional charge of the memory rather than grammatical accuracy. While the initial study had participants write by hand, subsequent research indicates that the positive effects are consistent, whether the writing is done by hand or typed. The podcast underscores the meticulous scientific rigor applied by Pennebaker in exploring the method across diverse populations, making this journaling protocol a powerful tool for improving mental and physical well-being. If implementing this practice, it is advised to choose a quiet, undisturbed space for the writing duration [2].

Figure 01. Neural contributors to trauma resilience [3].

References

2. Downey, C. and A. Crummy, The impact of childhood trauma on children's wellbeing and adult behavior. European Journal of Trauma & Dissociation, 2022. 6(1): p. 100237.

3. Roeckner, A.R., et al., Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies. Translational Psychiatry, 2021. 11(1): p. 508.

(03). 00:11:25 Tool: Expressive Writing

To ensure clarity on the journaling protocol used in over 200 peer-reviewed studies, Dr. James Pennebaker's initial instructions are shared, emphasizing the exploration of deeply held emotions and thoughts related to the most distressing life experience. Participants were encouraged to delve into how this experience connected to their childhood, relationships, and personal development. The directive allowed for a broad range of topics, including traumatic events or significant conflicts. The writing duration varied between 15 and 30 minutes, with no substantial differences observed in the positive impact on mental and physical health between the different time intervals. Participants were given the flexibility to choose the time frame that suited their need to fully express their thoughts and feelings about the chosen experience. The protocol's power lies in its adaptability, offering a structured yet personalized approach to exploring and processing challenging life experiences [4].

References

4. Gao, X., Research on Expressive Writing in Psychology: A Forty-year Bibliometric Analysis and Visualization of Current Status and Research Trends. 2022. 13.

(04). 00:14:38 Morning Notes, Gratitude Journaling, and Diary Journaling

Dr. Andrew Huberman distinguishes the transformative journaling protocol he discusses from other common forms of journaling, such as morning notes or gratitude journaling. Unlike morning notes, which aim to clear mental clutter through stream-of-consciousness writing, and gratitude journaling, which focuses on positive aspects of life, this unique method involves delving into emotionally charged, unfortunate experiences. It deviates from the autobiographical daily entries or diary-type journaling that many, including Huberman himself, engage in. While personal daily entries provide updates on life events, the discussed journaling protocol aims specifically at improving mental and physical health by addressing deeply distressing experiences. Huberman acknowledges the usefulness of other forms of journaling, citing data supporting the benefits of gratitude journaling in enhancing happiness, reducing anxiety, and improving relationships. The distinctiveness of the outlined protocol lies in its targeted approach to processing challenging life events for overall well-being [5].

Figure 02. Five facts about physiotherapy in mental health [6].

References

5. Roche, K., et al., Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers. J Pediatr Health Care, 2023. 37(4): p. 414-424.

6. Five facts about physiotherapy in mental health. Available from: https://australian.physio/research/prf/translation/five-facts-about-physiotherapy-mental-health.

(05). 00:18:00 Tool: Consecutive Writing Bouts; Trauma Definition

Dr. Andrew Huberman outlines the intensive nature of the journaling protocol, emphasizing its distinctiveness from other forms of journaling like morning notes or gratitude journaling. The discussed method involves writing continuously for 15 to 30 minutes about the most challenging experiences in one's life, with the recommendation to allow 5 to 15 minutes post-writing for emotional settling. The research indicates that subjects often experience distress, tears, breath-holding, and mental exhaustion during the writing block. To maximize effectiveness, individuals are advised to repeat the process four times, initially explored through four consecutive days of journaling for 15 to 30 minutes. While this may seem demanding, Huberman highlights the importance of acknowledging the intensity inherent in addressing deeply negative experiences. The protocol aims to bring about positive shifts in mental and physical health by confronting and processing these challenging life events stored in the nervous system, contributing to potential transformative learning. The podcast stresses the short-term nature of this practice and its potential for intense but impactful results [7].

Figure 03. The brain-body disconnect: A somatic sensory basis for trauma-related disorders [8].

References

7. Ana, S., Introductory Chapter: Psychological Trauma, in Psychological Trauma, S. Ana, Editor. 2019, IntechOpen: Rijeka. p. Ch. 1.

8. Kearney, B.E. and R.A. Lanius, The brain-body disconnect: A somatic sensory basis for trauma-related disorders. 2022. 16.

(06). 00:24:38 Low Expressors vs. High Expression

Deliberately journaling about distressing experiences can evoke various emotions like sadness, anxiety, frustration, or anger. When individuals engage in this journaling protocol, they tend to categorize themselves into two groups known as low expression and high expression, which are unrelated to introversion or extroversion. Low expressions use less descriptive language and display less emotion during the initial 15 to 30-minute writing, while high expressions employ more negative language to articulate their emotions about the distressing experience, experiencing higher physiological distress. Interestingly, low expression become progressively more distressed in subsequent writing sessions, whereas high expression show a reduction in distress over time. Despite these differences, both groups benefit from the protocol, experiencing significantly less distress three weeks, three months, and even years later, indicating lasting positive effects on mental and physical well-being regardless of individual expressiveness during the writing process [9].

Figure 04. The effect of anxiety on brain activation patterns in response to inspiratory occlusions [10]

References

9. Rosso, C. and I.A. Voutsadakis, Characteristics, Clinical Differences and Outcomes of Breast Cancer Patients with Negative or Low HER2 Expression. Clin Breast Cancer, 2022. 22(4): p. 391-397.

10. Chan, P.-Y.S., et al., The effect of anxiety on brain activation patterns in response to inspiratory occlusions: an fMRI study. Scientific Reports, 2019. 9(1): p. 15045.

(07). 00:29:29 Tools: Language, Vocabulary and Emotion; Analyzing Writing

Dr. Andrew Huberman delves into the significance of natural language patterns, particularly how the words we use in both spoken and written communication can reflect and even shape our emotional states. Referencing a study by Pennebaker and colleagues titled "Natural Emotion Vocabularies as Windows on Stress and Well-being," Huberman explains that individuals who naturally use more negative words tend to have more negative emotional states, while those favoring positive word patterns tend to experience more positive emotions. This finding goes beyond the simple knowledge of words and highlights the importance of habitual language usage in influencing mental and physical well-being. Connecting this insight to the discussed journaling protocol, Huberman suggests a post-analysis of the written entries, comparing the frequency of negative and positive words across the four sessions. The research indicates a noticeable shift in language patterns, with individuals using fewer negative words and an increase in positive words as they progress through the four writing sessions, even when describing the same negative experience. This emphasizes the transformative potential of the journaling protocol in reshaping not only how individuals express their distress but also how they perceive and communicate their emotions over time [11].

Figure 05. Perception of emotion in abstract artworks: A multidisciplinary approach [12].

References

11. Vine, V., R.L. Boyd, and J.W. Pennebaker, Natural emotion vocabularies as windows on distress and well-being. Nature Communications, 2020. 11(1): p. 4525.

12. Melcher, D. and F. Bacci, Perception of emotion in abstract artworks: A multidisciplinary approach. Progress in brain research, 2013. 204: p. 191-216.

(08). 00:35:02 Tool: Writing Session Tips

In this crucial phase of the journaling protocol, individuals are instructed to consider three key elements before commencing their writing sessions. First, they are encouraged to document factual details surrounding the difficult experience they aim to explore. Second, the emotional landscape is highlighted, prompting individuals to express both the emotions felt during the original experience and those emerging in the present moment as they write about it. Third, participants are urged to unravel and articulate any conceivable links between the past negative experience and current occurrences, plans for the future, or connections to people from the past, present, or future. The significance of inclusivity is emphasized, encouraging writers to capture both direct and opaque links. While maintaining a focus on complete sentences, the protocol prioritizes personal expression over perfect grammar or presentation. Dr. Andrew Huberman underscores the primary purpose of this writing: a personal journey to work through stress or trauma stored in the nervous system. Despite the acknowledged positive impact of using more positive words, the essence of the protocol lies in its cathartic and self-reflective nature, aiming to facilitate the resolution of distressing narratives. The subsequent discussion promises an exploration of the consequences when such narratives remain unaddressed and the substantial benefits—neuroplasticity, reduced anxiety, improved mood, sleep, and immune function—that emerge from completing the four sessions of 15 to 30-minute writing [13].

Figure 06. Role of sleep deprivation in immune-related disease risk and outcomes [14].

References

13. DiMenichi, B.C., et al., Effects of Expressive Writing on Neural Processing During Learning. 2019. 13.

14. Garbarino, S., et al., Role of sleep deprivation in immune-related disease risk and outcomes. Communications Biology, 2021. 4(1): p. 1304.

(09). 00:41:02 Positive Mental & Physical Benefits

Dr. Andrew Huberman delves into the substantial and enduring positive changes, both mental and physical, observed in individuals engaging in the prescribed four bouts of the journaling protocol. While clarifying that this practice doesn't serve as a complete therapeutic solution for major conditions like depression or post-traumatic stress disorder, the protocol has exhibited significant and long-lasting improvements in various health metrics. Studies, surpassing 200 in number and conducted across multiple laboratories, highlight benefits for those grappling with chronic anxiety, insomnia, arthritis, cancer treatment, lupus, fibromyalgia, and irritable bowel syndrome. Notably, the relief experienced is statistically significant compared to control groups engaging in more conventional journaling practices. The distinctiveness of the emotional content in the writing process emerges as a pivotal variable influencing the observed positive outcomes, fostering excitement and motivation for individuals to undertake this transformative writing protocol. Huberman teases the forthcoming exploration into the physiological underpinnings responsible for such remarkable shifts in both psychological and physical well-being [15].

Figure 07. Mental Health Benefits of Exercise and Physical Activity [16].

References

15. Brailovskaia, J., et al., The Benefits of Physical Activity and Positive Mental Health for Reducing the Burden of COVID-19: Validation from a Cross-sectional and Longitudinal Investigation in China and Germany. Int J Ment Health Addict, 2023. 21(2): p. 1186-1199.

16. Mental Health Benefits of Exercise and Physical Activity. Available from: https://www.nia.nih.gov/health/exercise-and-physical-activity/mental-health-benefits-exercise-and-physical-activity.

(10). 00:46:45 Expressive Writing & Immune Function; Brain-Body Connection

Dr. Andrew Huberman explores the profound physiological changes associated with the journaling protocol, supported by over 200 peer-reviewed studies. Focusing on a pivotal study by James Pennebaker, Huberman emphasizes the immune system's response to emotional disclosure during the writing exercise. Subjects engaging in the four bouts of expressive writing exhibited enhanced T-lymphocyte activation when challenged with an immune stimulant, particularly high disclosers, revealing a direct link between emotional intensity and immune response. Huberman delves into the emerging field of psychoneuroimmunology, highlighting Pennebaker's pioneering approach to investigating the intricate interplay between emotions, the nervous system, and physical health. The study's counterintuitive aspect, wherein deliberately inducing negative experiences yields positive health outcomes, prompts an exploration into the mechanisms underlying these transformative effects, transitioning into a discussion on neuroplasticity and the nervous system's capacity to rewire itself in response to emotional experiences [17].

Figure 08. Whole-brain mapping of effective connectivity by fMRI with cortex-wide patterned optogenetics [18].

References

17. Burton, C.M. and L.A. King, The health benefits of writing about intensely positive experiences. Journal of Research in Personality, 2004. 38(2): p. 150-163.

18. Kim, S., et al., Whole-brain mapping of effective connectivity by fMRI with cortex-wide patterned optogenetics. Neuron, 2023. 111(11): p. 1732-1747.e6.

(11). 00:58:10 Neuroplasticity, Prefrontal Cortex & Subcortical Structures

The transformative effects of the expressive writing protocol can be attributed to the neural mechanism of neuroplasticity. Neuroplasticity, the brain's ability to change in response to experience, is particularly influential when recalling traumatic or stressful events. Childhood neuroplasticity occurs passively, forming predictive maps during critical periods. The writing protocol taps into these neural maps by prompting individuals to recount facts, emotions, and associations related to a distressing experience. Traumas and negative states often involve reduced prefrontal cortex activity, affecting contextual planning, identity, and decision-making. The subcortical structures, including the amygdala and hypothalamus, become more dominant in stressful situations. The expressive writing protocol serves as a Lynchpin mechanism, reactivating the prefrontal cortex, fostering neuroplasticity, and reshaping the neural networks associated with stress, leading to profound and lasting positive shifts in mental and physical health [19].

Figure 09. Prefrontal cortex, amygdala, and threat processing: implications for PTSD [20].

References

19. Luciana, M. and P.F. Collins, Neuroplasticity, the Prefrontal Cortex, and Psychopathology-Related Deviations in Cognitive Control. 2022. 18(1): p. 443-469.

20. Alexandra Kredlow, M., et al., Prefrontal cortex, amygdala, and threat processing: implications for PTSD. Neuropsychopharmacology, 2022. 47(1): p. 247-259.

(12). 01:05:00 Structured Writing, Trauma & Narratives; Truth-Telling

Neuroimaging studies, particularly those conducted by the Liberman Laboratory at the University of California, Los Angeles, reveal that when individuals recount highly stressful or traumatic events, the prefrontal cortex exhibits reduced activity compared to recalling less distressing events. Simultaneously, subcortical structures, including the amygdala and hypothalamus, show increased activity during the initial recollection of traumatic events. However, the key insight lies in the structured or semi-structured revisiting of these distressing events through the expressive writing protocol. As individuals progress from an unstructured narrative to subsequent bouts of more coherent storytelling, the prefrontal cortex's engagement gradually increases. This deepening of recollection, despite potentially heightened distress, contributes to a more factual and truthful account of the traumatic experience. This truth-telling component is crucial, emphasizing that the events themselves are unalterable, but the narrative's coherence evolves, leading to improved symptomology related to trauma and stress over time [21].

Figure 10. Hypothalamus and amygdala functional connectivity at rest in narcolepsy type 1 [22].

References

21. Lieberman, M.D., et al., Putting Feelings Into Words. 2007. 18(5): p. 421-428.

22. Ballotta, D., et al., Hypothalamus and amygdala functional connectivity at rest in narcolepsy type 1. NeuroImage: Clinical, 2021. 31: p. 102748.

(13). 01:08:56 Neuroplasticity, Truth-Telling & Relief from Trauma

The paradoxical nature of the expressive writing protocol's effectiveness in alleviating the negative impact of traumatic or stressful experiences becomes clearer when considering neuroplasticity and the interplay between the prefrontal cortex and subcortical structures. While initial trauma diminishes prefrontal cortex activity, inhibiting coherent narrative construction and fostering confusion about responsibility, engaging in structured expressive writing serves as a powerful tool. By revisiting the distressing events in detail over four sessions, individuals deepen their recollection, enhancing the coherence of their narrative. The act of truth-telling about these experiences triggers heightened emotionality, a state crucial for inducing neuroplasticity. Contrary to the logical expectation that stress exacerbates prefrontal cortex dysfunction, the deliberate reexperiencing of stress through expressive writing fosters increased prefrontal cortex engagement. This heightened activity contributes not only to a more accurate and coherent understanding of the traumatic event but also facilitates neuroplasticity that aids in regulating subcortical structures. Ultimately, this counterintuitive process enables relief from the negative impacts of traumatic experiences, shedding light on the intricate relationship between emotional expression, neural function, and mental well-being [23].

References

23. Peckham, H., Introducing the Neuroplastic Narrative: a non-pathologizing biological foundation for trauma-informed and adverse childhood experience aware approaches. 2023. 14

(14). 01:15:32 Honesty, Brain Activity & Narratives

An intriguing experiment titled "Increasing Honesty in Humans with Non-Invasive Brain Stimulation" explored the link between prefrontal cortex activity and truth-telling. In this study, participants engaged in a dice-rolling game where they could win monetary rewards based on accurate reporting. Interestingly, individuals tended to dishonestly claim matches around 68% of the time. Using transcranial magnetic stimulation, researchers targeted the dorsal lateral prefrontal cortex and found that stimulating this area significantly increased honest reporting, bringing the rate down to 50%. This suggests a compelling connection between prefrontal cortex engagement and truthful representation. Subsequent studies supported the idea that truthful reporting triggers neuroplasticity in the prefrontal cortex, fostering a coherent understanding of traumatic experiences and potentially contributing to the observed positive effects of the expressive writing protocol [24].

Figure 11. Unpleasant truth about another person activates the anterior insula and medial prefrontal cortex [25].

References

24. Maréchal, M.A., et al., Increasing honesty in humans with noninvasive brain stimulation. 2017. 114(17): p. 4360-4364.

25. Littlefield, M.M., et al., Being asked to tell an unpleasant truth about another person activates anterior insula and medial prefrontal cortex. 2015. 9.

(15). 01:22:01 Overcoming Trauma & the Brain; Stress, Emotions & Honesty

Recent studies indicate a growing consensus among researchers, termed "truthtellahs," about the positive shifts in immune system function and overall health following the recounting of traumatic events. This phenomenon, though initially counterintuitive, finds its explanation in the intricate connection between the nervous system, the brain, and the body. The prefrontal cortex, a flexible hub of cognition influencing self-representation and regulatory functions, plays a pivotal role. When this region organizes its understanding of autonomic nervous system activity during stressful events, it seems to reduce unwarranted activation, contributing to a range of positive outcomes, from anxiety reduction to improved sleep. The interplay between the nervous system and the immune system becomes evident, challenging previous siloed views in immunology, brain science, and psychology. The discussed expressive writing protocol, focusing on recounting truths about events, emotions, and connections, emerges as a stimulus for neuroplasticity. The associated emotional engagement facilitates positive mental and physical shifts, accelerating progress in treatments for conditions like depression and PTSD when combined with other therapeutic approaches [26].

Figure 12. Mild Traumatic Brain Injury and Their Association With Clinical Cognitive Performance [27].

References

26. Globig, A.-M., et al., The β1-adrenergic receptor links sympathetic nerves to T cell exhaustion. Nature, 2023. 622(7982): p. 383-392.

27. Vedaei, F., et al., Resting-State Functional MRI Metrics in Patients With Chronic Mild Traumatic Brain Injury and Their Association With Clinical Cognitive Performance. 2021. 15.

(16). 01:26:41 Expressive Writing Protocol & Benefits

The journaling protocol devised by Pennebaker and colleagues stands out for its cost-effectiveness, emotional intensity, flexibility, and well-documented long-term positive effects on both physical and mental health. The protocol, requiring participants to write about the same event for four consecutive days within a month, allows for a 15 to 30-minute time commitment per session. Emphasis is on continuous writing, overlooking grammar concerns, while focusing on factual details, emotional responses, and any associated thoughts. The flexibility of implementation—whether in four consecutive days or spaced across a month—acknowledges the diverse preferences of individuals. The protocol, while intensely emotional, is designed for personal use, discouraging casual sharing due to the potential for inducing thirdhand trauma in listeners. The key is to truthfully recount experiences, emotions, and connections, with a recognition that the immediate aftermath of each writing episode might bring about heightened negative emotions. Importantly, participants are encouraged to prioritize their mental and emotional well-being and discontinue the protocol if it becomes excessively distressing. Overall, this writing exercise offers a powerful, evidence-based tool for individuals seeking to navigate and potentially heal from stressful or traumatic experiences [28].

References

28. Pennebaker, J.W., Writing About Emotional Experiences as a Therapeutic Process. 1997. 8(3): p. 162-166.

Paper

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