Patients find solace in journals

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Writing encourages people with cancer to express emotions

Chris Swingle

Staff writer

(May 3, 2006) — Having lung cancer has prompted a range of emotions for Kathy Vahue over the past seven years.

But it wasn't until a recent guided journaling class for people with cancer that she uncovered some of them. Through writing exercises, she recognized the joy of her strengths. She also realized she felt lingering anger about a health care provider's insensitivity years ago.

"I wrote him a letter and told him exactly how I felt," says Vahue, 66, of Penfield. She felt a release once she got it on paper and disposed of it.

The six-week journaling class concluded in mid-April with an outdoor burning of such letters in a metal pot. "When you see that smoke go up ... I just realized, let that anger go, let it evaporate with that smoke," Vahue says. "I don't have enough room to carry old anger."

Journaling can be a powerful way to explore and cope with feelings. Research finds that journaling can reduce anxiety, blood pressure and depressive symptoms, while boosting the immune system and helping people think more clearly, says Janice Putrino, a social worker at Gilda's Club in Rochester who is trained in teaching journaling.

Facing a blank page alone, however, can produce anxiety rather than healing. Putrino and Linda Sliwoski, a senior nurse manager of Rochester General Hospital's Lipson Cancer Center who's also trained in journaling, are each offering structured classes for people with cancer. Probing questions and activities help people start writing.

"The goal of journal writing is to become more balanced," says Putrino. "When they begin to write, they're able to put their finger on what's really going on."

Putrino had journaled herself but never stuck with it until she took the training course. The writing exercises helped her clarify her thoughts and communicate better verbally. She also experienced healing and peace about experiences from her past. "I felt myself growing as a person," she says.

Putrino had already facilitated therapeutic discussion groups at Gilda's Club for people living with cancer. Writing helps people go deeper, she says.

With a one-year grant from Roche Laboratories, Putrino is working to expand cancer journaling in the Rochester area. She explains journaling's research-based benefits at presentations to health care providers. She's also starting a journaling group for medical professionals, to help them deal with the stress of working with patients with life-threatening diseases.

"It's a catharsis," says Sliwoski, who has been journaling for 16 years.

The discipline of writing at a class and having homework to do has helped Joe Nagel, 46, of Ontario, Wayne County, to make writing a habit. He's taken journaling classes at Rochester General and at Gilda's Club.

He says his instinct is to notice the things that aren't going right in his life, but the writing tasks have helped him focus on positives. Nagel has non-Hodgkins lymphoma, diagnosed four years ago while he was going through a divorce.

"A lot of the benefit of journaling is sorting through the head and the heart of thoughts and emotion," says Nagel, who often carries his journal with him. "Writing them down takes them out of your head."

Participants in both Sliwoski's and Putrino's classes are given a free (courtesy of Roche) self-guided journal, My Healing Companion, which has blank pages interspersed with chapters on cancer-related experiences and feelings. Author Beverly K. Kirkhart of California has been a breast cancer survivor since 1993. Kirkhart's book addresses "why me?", anger and fear. It explores reaching out for support, finding courage and hope, communicating with doctors, getting hugs, dealing with the blues and feeling beautiful.

Journaling classes also draw from Kathleen Adams' book, Journal to the Self, which is not particular to cancer. It calls for writing paragraphs but also other approaches, such as making lists. For example, try writing as much as you can for five minutes straight, answering: What is my body trying to tell me? What brings me joy? Or, what am I afraid of?

Another exercise: List 100 things that you need to do or want to do before you die, or 100 things that make you happy. Then organize the list into categories to see the overall trends.

Those approaches are said to engage the left side of the brain. Stimulating both sides of the brain is helpful, Putrino says. A right-brain activity: Create an imaginary dialogue between you and another person and write out both sides of the conversation to see where it goes. Or write as if you're having a talk with your cancer or with a difficult emotion.

Vahue has written in her journal about surviving, noting the glory of sunrises and the joy of being alive: "The fact that I'm here is a major victory."

CSWINGLE@DemocratandChronicle.com