When a new patient arrives in my office by the end of that first session they get a gift. A journal. Now, I wish I could tell you that I gave them a fancy,leather-bound , gold-gilded edge fancy journal that cost almost as much as the session to see me. But alas, I start them with a regular composition book-you remember the type we had to write in during high school. If Target or Wal-Mart are offering a good selection I try to get different colors or patterns on the front.

YOU MEAN SEEING YOU ONCE A WEEK ISN’T ENOUGH…I HAVE HOMEWORK?

Well, to be honest. Yes. Seeing me means you have homework. The bottom line is that I believe that getting people better means that the more work you do in between sessions means the more work we will get done in the therapy session, and the faster you will get through  your pain, sadness, fear, or whatever you are seeing me for. Gone are the days when people saw a therapist 5 days a week, as if they were in their own Woody Allen movie. With the economy the way it is, daily psychotherapy is expensive. And most people don’t have the time to take an hour out of their work day to work on fixing their non-work life.

When people get their Journal they usual give me a panicked look. First rule is that I am not going read it, this is for you. Your thoughts, feelings, poems, drawings, cut and paste out of your favorite magazines are all private. You can write, draw, color or paste whatever it is that you are feeling right then or earlier today, yesterday or 10 years ago. Whatever has popped into your mind. When people get stuck about what to write, I usually tell them “Just start out with ‘I feel…’ and then write one feeling. If nothing else comes. That is ok. This is not being graded. You can’t flunk therapy, honest. If you don’t know how you feel then just borrow your child’s crayons or some of your highlight markers and scribble what you feel. When people do chose to bring their journal’s in to share with me, they have shown me large black and red dark scribbles when we discussed what was going on that day, often they were very angry but they had received a childhood message that it was not safe or appropriate to verbally express anger. So they had become experts at stuffing it down. (Oh, psychology 101- depression is often repressed anger). I promise, the more you write, the easier it becomes. And the more feelings your write down on paper, the less get stuffed down feeding that big depression monster in the pit of your stomach. And if you write it down first, you will find that it’s easier to tell me about it the next session if you choose. And, if you don’t feel comfortable telling me you can bring your journal and READ the parts you want me to know out loud! You are in complete control.You hold the journal. I don’t peak, or try to take it. Other uses for the journal are often patients bring them to write down other homework assignments, or books you might want to read ( yes, I believe in Bibliotherapy too), or other bits of information that we discuss that you may want to remember.

Will This Be On The Exam?

Often in University and Graduate School my class would be frantically scribbling down notes on ever word that slipped out of our professors mouths (please remember this was in the dinosaur age before we could bring laptops to class…there were no laptops. It was my lap. a yellow legal pad, and a bunch of pens in my purse or backpack). When something was mentioned that we weren’t sure was of importance, eventually someone, no doubt hiding out in the back of the room, would yell out , “Will this be on the Final?” That was our way of essentially asking, “Is this really important or shall I just not bother writing it down and forget?”  This frantic look that we all no doubt had on our faces while waiting for the response to that all important question, I now occasionally see staring back at me when I hand my patients their journals. Not to be sexist, but that look usually stares back at me from my male patients. They often want or need an assignment or specific directions. I don’t think this has anything to do with right brain/ left brain, or ability to express feelings. I think it’s as simple as the fact that very often little girls were given pretty pink diaries with a locket and gold key that they either hid or kept around their necks. Girls were encouraged at a fairly young age to write down all of their secrets. So for my female patients, many of them already have journals or diaries that they had kept for decades. Some would politely refuse my less than attractive composition book, saying they would rather use their own pretty diaries, others decided that perhaps using a new one as an ongoing documentation of their therapeutic experience in order to separate it from the other things that they wanted to write about was a good idea.

So initially my male patient’s wanted directions, or assignments. But as time passed and they wrote about dreams, and arguments, thoughts and feelings, they realized that they didn’t get yelled at when they told me they weren’t writing. This silly little composition book became their Oprah Ah Ha moment!  This could be their safe place. They soon discovered that they could go back and reread their journals and begin to see patterns – about their emotions, arguments, their relationship, work, people in their lives. And the pieces of the puzzle that were thought to be missing started to fall into place. When they were able to write or draw their feelings, they could talk about them more easily.

 What was that middle part, um…about assignments?

Sometimes I do give assignments. To be honest, I don’t ever know when I’m going to give one .It simply grows out of the work we do. I do a lot of creative therapy. Sometimes we draw, or use clay, or even use the curious sandbox I have near the fire place…in front of shelves and shelves of plastic animals, people, trees, figures, crystals, anything you might imagine.And when I say “WE” I mean “WE.” We do these exercises together-no adult likes to be started at by some note taking individual while they mess with crayons or sand trays. Also, if we had a very simple “talk therapy” session, often I would have an Oprah Moment and I’d suggest something for them to write about.

How do I keep my journal from being read by my partner?

Well, after decades of doing this, my best suggestion for this is to hide it between the box springs and mattress on your bed. Now, if your partner is the one changing the sheets,either make sure that journal is way in the center, and removed on flipping the mattress day, or you can keep it in whatever place is safe for you. Some people prefer to use their computers and lock their word documents. That is fine, although occasionally I use an exercise where I have you write with your non-dominant hand. And that is kinda tricky when you are typing.But, I’m creative. You can use the computer for all of your entries, and then just use the composition notebook if we do something that needs you to draw or write with a different hand. Easy Peasy.

But aren’t there rules?

There is one part I forgot to mention: the rules. There are none. Well, actually there are two. You have the right in my office to to be safe. So, if I ever give you an assignment or suggest something to write about in your journal, or discuss in my office and you feel scared, all you have to do is say the 2 magic words. Stop or No. And if the words won’t come out, all you have to do is raise your right hand.

And. We. Stop.

If you want one of my special journals with all my assignments give me a call, and I’ll make sure you have one on your first session. I’ll be writing another blog on getting set up, (a good pen is very important especially if you have Rheumatoid or Inflammatory Arthritis-they have larger pens that  are a bit more expensive but are more comfortable for your hand) and some ideas on things to write about to get you started. So if you want to start writing today, Target or Walmart usually have the best sales right before school start, that’s when I stock up. See you in the school supply aisle!

Gentle Hugs,

Dr Karen Hoving