Man writing in a journal practicing self-care

A Psychological Journal as Self-Care

Tom Ferguson, M.D. interviews Ira Progoff, Ph.D. about journaling as a self-care tool to help you deal with difficult times in your life, times of change, decision, or loss.

After working in the Intensive Journal on my own for several months, I decided to attend a Progoff workshop at a Catholic retreat house in Menlo Park.

The most striking thing about an Intensive Journal workshop is that so many people come together to work alone. Each of the hundred participants sat, focused quietly inward, notebooks in laps, working with the materials of his or her own life; while Progoff, a kindly, soft-spoken man, short and rather shy, sat in a swivel chair on a raised platform and, sometimes, talked. His talking, he explained, was to be regarded as background music to the primary focus of the workshop, each-person’s self-directed writing.

He led first-time journal users through some introductory exercises, while those more experienced with the journal (many brought in binders bulging with pages, clearly the accumulation of years) worked away on their own, stopping to listen at times, going on when the spirit moved them.

The atmosphere was quiet, focused but relaxed. Participants were invited to make their own breaks, and from time to time someone would move silently in or out of the auditorium. Cocoa, tea, coffee, and several boxes of fresh apricots were available in a room next door. It all felt a little like being in church.

A number of the participants were, in fact, from religious vocations, but while the journal is open to religious use, participants must supply their own religion. After an exercise in which we were asked to have a dialogue with our own interior wisdom figure—a conversation with a person, real or imaginary, living or dead, whom we most admired and respected—there was mention made, in the coffee room, of Jesus, Moses, God, Picasso, Martin Luther King, St. Theresa, Lao-Tze, Malcolm X, Saul Minsky, William Blake, and Margaret Sanger.

The workshop ended on noon of the third day. Progoff had promised to meet me for an interview afterward, but first wanted to make himself available to participants who wanted to see him privately. He ended up meeting at some length with more than a dozen, exhibiting a remarkable patience considering that he had been working sixteen hours a day for nearly a week. It was late afternoon by the time we settled onto wooden deck chairs on the front porch of the retreat house and taped the following interview.

TF: One thing we’ve been trying to do in the magazine is to point out ways to move the focus of health responsibility from some kind of expert back to the individual himself. It seems as if you’re trying to do something very similar with the Intensive Journal

IP: Yes, I would certainly hope so. Emerson’s essay on self-reliance has always been one of my favorites. I see psychological self-reliance, or psychological selfcare, a way of being able to tap into resources and knowledge within oneself that can enable us to deal with our problems, our experiences, in new ways. That’s the principle I’ve tried to build into the Journa!.

You studied with Carl Jung for several years. Didn’t he have his patients keep a journal?

Jungians always keep a dream log and a kind of general inner diary. The problem with an unstructured journal, including many of the Jungian ones, is that they tend to go around in circles, and they only work in very limited ways. The Intensive Journal is set up to help you break out of that circular movement.

We were talking earlier about E.F. Schumacher and the appropriate technology movement. Do you think of the Journal as appropriate psychological technology?

It really sounds very similar, doesn’t it? I know I’ve felt for a long time that many psychologists and psychiatrists are trained to rely too much on what you might call inappropriate psychological technologies— ways of taking over diagnosing and controlling psychological problems with drugs or electroshock or whatever. I think good therapy is very often more a matter of helping someone who’s stuck get unstuck. I think people are much more capable of guiding their own efforts to get unstuck than we’ve given them credit for.

Has the Journal been used with people in mental hospitals?

I had never thought the Journal could be used by very disturbed people, but we’ve had a most interesting experience using it in this way at St. Luke’s Hospital in Phoenix. They had about thirty or thirty-five psychiatric patients on their acute crisis ward, and they invited me in to do three short workshops. The were open to everyone on the ward, no matter how disturbed. It was very interesting.

There were people there who hadn’t spoken in as long as they’d been there, they were diagnosed as catatonic. I gave them the stepping-stones to do and they did them and read them out loud. Two young guys were there as depressives. After the workshops I was walking through the ward with the head nurse. She said to them, “Hello, how are you?” And they said, “Fine,” and gave us a big smile. She turned to me and said, “Those two fellows haven’t smiled or done more than grunt in the two days they’ve been here.”

Word came back to me later that the senior psychiatrist, who specializes in electroshock, said he would not have believed it possible for so many seriously disturbed people, with no restrictions, to experience nothing negative and so much that was positive and integrating.

So we’ve been following that up by starting a program to train some of their people to teach the Journal on the ward, and then to have programs available in the community so people can continue after they’re re-leased.

What could you say about the Journal as a possible tool for our readers to use in their own lives? Who might find it useful? What would it be useful for? How could they go about giving it a try?

You can learn to use the Journal either from a workshop or from my book, At a Journal Workshop. The first exercise, the Period Log, is designed to give you a kind of overview of your life, with particular attention to the most recent period of your life. It might be a good introduction to do that exercise and see if it feels like a way of working that is right for you.

As to what the Journal is useful for, I like to describe it as an instrument—in two senses. First, it’s an instrument like a hammer or a scalpel—a tool to help you deal with difficult times in your life, times of change or decision or loss, or great success for that matter.

But it’s also an instrument in the way that a piano or violin is an instrument. Working in the Journal can be a fulfilling experience in its own right, an art form if you like. It’s something you can do just for the pure pleasure of it. You can play with it. Improvise.

Do you recommend that people write in their Journal every day?

It’s entirely up to the individual. A few people keep it every day. It’s not like keeping a diary. It’s something that’s there for you when you want it, when you need it. It’s more like “Gee I’ll think I’ll get my guitar out and play a little.” It’s definitely not supposed to be another responsibility to feel guilty about.

How would you compare learning the Journal from the book to learning it from a workshop?

It’s probably easier in a workshop, though of course coming to a workshop is not always convenient. If you can do it, though, a whole weekend away from home can be a real help in getting deeply into it in a short time. It gives you a chance to block off all outside pressures and just focus on the movement of your life.

Learning from the book is certainly more convenient. It probably works best if you can give yourself some big blocks of time, at least in the beginning.

You were saying you’re now working to make the Journal workshops more widely available.

Yes. We’re now working with a number of local groups across the country—churches, community mental health centers, adult schools, universities—to help them set up and run a program of local Journal workshops.

How might that work?

Well, suppose a minister or a therapist has someone in a crisis situation and both counselor and client have been trained in the Journal method. Perhaps the client has tried to work it out for himself in the Journal but hasn’t been able to.

The client could bring in his or her Journal, maybe read some of it if he chose, and the counselor, in addition to doing some individual therapy, could suggest some specific work in the Journal that might help. We’ve developed some specific exercises, a kind of crisis module, to be used at such times.

If some of our readers belong to organizations that might be interested in sponsoring a workshop, would you encourage them to contact you?

Oh, yes. Definitely.

How have other mental health professionals responded to the Journal method? I would think that some might find it a little threatening.

Well, of course, the ones we’ve been in touch with are the ones who like it and use it. A number of psychologists and psychiatrists are incorporating the Journal into their therapeutic work.

It turns out to be quite adaptable. One of the appealing things about this method is that it isn’t instead of anything else. It doesn’t promote or contradict any psychological or religious explanation of the nature of man. Freudians can use it. Gestaltists can use it. Behavior therapists can use it. Fundamentalist Baptists can use it. Suns can use it. We’ve had people from just about every possible religious or philosophical orientation use the Journal successfully. We have Catholic monks and Zen Buddhists sitting side by side in our workshops.

It sounds like you’re working toward a vision of a whole new way of approaching the area of mental health care.

Yes, and I’m very encouraged by what you’ve told me of the self-care movement in the area of physical health. I would hope that the Journal could be an important tool for a similar emphasis on psychological self-care.

The basic concept behind the Journal method is that when you’re having a hard time, when you’re troubled, it doesn’t mean you’re sick. It doesn’t mean you should immediately go out and put yourself under an expert’s care. It may mean that you’re in transition, that things are pretty confused for you right now, but that’s all right. That’s natural. It’s a part of the unfolding process of life, as it moves from cycle to cycle.

When you’re in a great darkness or feeling very depressed or a lot of anxiety, there are methods of working that will allow our life to tell us what it’s seeking to achieve beyond that blockage, beyond that stuck point.

When you use the Journal, you’re not saying, “I’m sick,” you’re saying, “I need a time of reflection, of quieting. I need a sabbath.”

I think the principle of the sabbath—the need for rest after activity—is still psychologically sound. It may be that the rhythm of six and one is not the only rhythm. The Journal is a way to follow one’s own rhythm, to create one’s own personal sabbath, whether you come to a workshop or just do it privately in your own life.


Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher and one of the earliest proponents of self-care. Dr. Ferguson studied and wrote about the empowered medical consumer since 1975 and about online health resources for consumers since 1987. After attending Reed College, earning a Master’s Degree in creative writing from San Francisco State University, and a medical degree from Yale University School of Medicine, he launched a prolific career in consumer focused medical writing as founder of Medical Self Care magazine. Tom was in charge of “Self-Care Central” one of the 10 “buildings in Healthy’s original Health Village design on our original website launched in 1996. This interview was drawn from the archives of Tom’s Medical Self-Care magazine. It is as relevant today as it was 30 years ago. Tom passed away in 2006. He has so much more to offer the world.

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Written by Tom Ferguson MD

Explore Wellness in 2021