20 Journal Prompts to Help Chronic Illness Patients Cope with All. Of. This.

When I was little, my grandfather and I used to sit at the kitchen table writing stories onto Post-It notes. Sometimes, when I was learning to write, we’d copy stories directly from books. I loved the way my handwriting shaped itself onto the page. I found myself covering post-it note after post-it note with little stories and poems and thoughts. I often wrote about the earth (I was a sensitive child, in tune with nature), about the way we should treat it, about islands and oceans.

I still have some of these sticky notes.

Tragically, my grandfather developed emphysema after he left the Navy and entered the workforce. He passed away at the young age of 63. As he was spending his last months on earth — unbeknownst to me in my blissfully ignorant child’s mind — he thought of ways to spend time with me before he left this earth.

One day, he brought a calligraphy set home, set it upon the table, and taught me how to draw the letters. I found the act itself a place that felt like home. In writing, I found myself. To this day, it gives me a sense of comfort and family, a ritual act tied into my upbringing and true self.

After his death — and throughout my whole life; here I am, doing it again! — writing became a way to explore myself and to move through pain. It came naturally to me. I believe this was his parting gift to me — giving me a way to express myself honestly.

Now, I help others do it, too. I even wrote a book about using writing as a ritual and healing act.

Right before the COVID-19 pandemic hit, I started taking a Journal Therapy certification course, and I’m so glad I did. It solidified what I always knew to be the case: Writing can help us admit to our feelings, accept our fear, manage our anxiety, and move through serious trauma.

How Writing Helps Us Cope

According to the American Psychological Association, expressive writing (writing about your thoughts and feelings) has helped boost immune health and support overall health in patients with asthma and rheumatoid arthritis. Another study found that writing can help improve our resilience in traumatic times. There is even evidence that writing help connect us to a deeper spirituality.

It’s safe to say that COVID-19 is, in many ways, traumatizing us all in various ways — through sickness, anxiety and depression, financial loss, loss of routine, sudden change, and the impact it has on the chronically ill.

As someone living with ankylosing spondylitis (AS), a form of inflammatory arthritis, the coronavirus pandemic has destroyed many of the daily routines I rely on for self-care.

I can’t go to the gym or get as much physical activity as I normally do (movement is a huge part of how I manage my condition) and I definitely can’t go swimming, which has been the one thing I rely on to seriously manage my pain.

My AS pain levels have kicked up due to stress, and then the stress leads to more pain. A cocktail of grief, worry, and uncertainty has made it hard to get out of bed, throwing off my work.

It’s hard to be a chronically ill person on any given day; in this coronavirus world, we have to worry about staying safe and healthy, making ends meet, and caring for our high-risk bodies. It’s a lot.

So I’ve turned to therapeutic writing. It is my home, my safe space, my palace of introspection and strength. It’s free and it’s always available — at midnight when my mind is racing or between work assignments.

Journaling through the coronavirus pandemic was even offered as a counseling tool by counseling services at Connecticut College. Because it works. Whether you’ve never written before, kept a diary here and there, or are a diligent daily journal keeper, writing allows us to be honest and authentic in an uncensored environment for the sake of documentation and personal growth.

Research shows that when we’re honest with ourselves, we can begin to take action and find strength. More often than not, we are more resilient than we think we are. Writing allows us to get the worry outside of our bodies so that it doesn’t rule us. We can rule it.

When we’re stuck inside the house and dealing with fear on a global level, we all experience tidal waves of emotions. And they will probably change day to day, or even hour to hour.

I’ve vacillated between fear and anxiety and work, work, work to distract my mind. I feel sad and hopeless and then inspired and hopeful. And of course, each and every one of my emotions is connected to my body. When I feel safe and hopeful, my body, like a plant, reacts as if it’s been watered. I can feel my pain levels and fatigue decrease a bit. But when I don’t care for myself or obsess over the news, I can feel my back seize up. I can feel my body lose strength.

Journal Prompts for Chronic Illness Patients

So, here are some of the journal prompts I’ve been exploring. They intersect wellness, worry, and chronic illness. They won’t stop feelings of pain, grief, or fear. But I hope they will help you gain control, insight, and self-compassion.

You might do one or two a day, or return to the same prompt over time to see how you react to it and how your reactions change — especially as our time in quarantine goes on.

1. Where are you feeling pain or exhaustion in your body? Is the pain associated with a specific feeling? For example, is anxiety making it hard to sleep? Have you felt more back or neck pain in quarantine? Tap into your body and acknowledge it. 
2. Are there things that you can control — even from within quarantine — that can help reduce your pain or stress levels? 
3. How does staying inside impact your physical and self-care routines? How can those routines be adapted to your quarantine and coronavirus reality? 
4. Write a letter to your body. What would you say to it as it experiences fear, uncertainty, and anxiety? 
5. What are the things that you can rely on to help you find stress relief? It’s often fun to write these onto a big piece of paper, colored in or designed with illustrations. List every single stress relief tool so that you can refer back to this page as a toolbox.
6. How have anxiety and fear changed your relationship with your illness? 
7. What have you endured, survived, and conquered in your life in with regard to your illness? What have those experiences taught you about survival, change, and traumatic experiences?
8. Imagine a safe space that is inviting, calming, and recuperating. What does it look, feel, smell, and sound like?
9. Write down your current emotional, physical, and mental needs. How can you find ways to fulfill them during the day?
10. Do you have health anxiety? Is the coronavirus pandemic making it worse, or harder to cope? Can you explore some of the reasons why — along with some of the facts that keep you grounded? How can you prevent catastrophizing?
11. Are you being kind to yourself in this hard time? How can you be kinder to yourself?
12. When you begin to worry about your body and health, what can you do to get control and seek support? Who is part of your support team?
    
13. Write a letter to yourself about adaptability and resilience. What has your body taught you? How can it help get you through worry around the coronavirus?
    
14. Do you feel out of control? If so, why? What are some of the ways you do have control? How is control connected to life with a disease? Has your disease made control seem appealing, or has it inspired you to let go of control a little more?
15. What are five things you can do right now that can support your mental and physical well-being after a night of falling into a bad news spiral? How can these things help your stress levels and your disease?
16. In which ways do your mental health and your physical health connect? Do you notice changes in your pain or fatigue when you are stressed out?
17. Is the quarantine causing accessibility issues for you? How is this making you feel — and what are the ways you can help some help?
18. How are others making you feel about your quarantine experience and feelings? 
19. What does it look like when you show yourself compassion, patience, and love during hard times? How does this benefit your body and mind?
20. Picture yourself surrounded by joy. What is joy? What is its shape, color, sound, or texture? Picture yourself being encompassed by it and held up in its arms. How do you feel? How does this help to provide support for your body and mind? 

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