Visual Journaling: Health Promotion through Art and Drawing

What is visual journaling? 

Visual journaling [also called art or drawing journaling] has been identified as both an important and accessible approach in expressive arts therapy, counseling, and education. It is not only an effective method for stress reduction, but also is considered a creative way to express personal narratives and life stories as well as make meaning through images, creative writing, and story sharing.  

Why combine images with words?   

In a comparative study on the efficacy of art and writing therapy on stress reduction, Pizarro (2004) noted that the combined effects of art therapy and writing demonstrated more significant positive changes in terms of perceived levels of stress than writing alone.  

History of visual journaling 

Visual records of thoughts and daily life have been maintained throughout history. Petroglyphs (rock carvings) and pictographs (rock paintings) are the oldest forms of symbolic language representing complex cultural meanings often layered over time. Japanese 10th century “pillow books” were private written and visual journals (collection) depicting personal thoughts, feelings, and reflections about court life (Kasahara, 2017). Indigenous methods of recording historical events are also typified in the Lakota Winter Counts: a storyteller creates a pictograph for every year (snowfall to snowfall) on hide or cloth (Atka Lakota Museum & Cultural Center, n.d.).

Benefits of visual journaling 

There are a number of proven health benefits correlated with visual journaling or artmaking.  For instance, engaging in brief artmaking has been shown to enhance immunity and decrease cortisol levels (Lorance & Warson, 2012; Hayes et al., unpublished raw data).  Although, many of these benefits can be transferred to the effects of the visual journaling process, research on the specific effects of visual journaling demonstrated a decrease in anxiety levels and negative affect (Mercer et al., 2010).  

In a 2012 study with southeastern tribal elders, visual journaling was sustained over a two-month period with a 95% response rate among 26 participants (Warson, 2012). Preliminary data analysis indicated a preference for depicting every-day life events such as picking peas in the garden, designing quilt patterns, as well as references to family and spirituality. These preliminary findings suggest that mindfulness-based awareness was evident in the re-experiencing of important daily tasks and events. As a result, there is growing evidence for visual journaling as a promising intervention for stress reduction. 

Guidelines for visual journaling  

For maximum benefit, choose a consistent time of day to work in your journal.  Keep a small container of favorite art supplies close by in addition to a small travel case. Health benefits such as increased dopamine and serotonin production can be achieved after five minutes of sustained visual journaling (Zaidel, 2014).   

Research on visual journaling has demonstrated that a self-directed approach is just as beneficial as using specific prompts (Mercer et al., 2010). Create your own approach and vary it as your awareness grows. For example, visual journaling process over a period of time can elicit new themes as broad as your depiction of wellness. Mindfulness-based practices are also a natural fit with visual journaling.   

Suggested visual journaling exercises 

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Atka Lakota Museum & Cultural Center, (n.d.). Lakota winter count. 

Mercer, P., Warson, E., & Zao, J. (2010).  Visual journaling: An intervention to influence stress, anxiety, and affect levels in medical students.  The Arts in Psychotherapy, 37(2), 143-148. 

Kasahara, Z. (2017, Feb. 2). The pillow book. 

Pizarro, J. (2004). The efficacy of art and writing therapy: Increasing positive mental health outcomes and participant retention. Art Therapy: Journal of the American Art Therapy Association, 21(1), 5–12. 

Warson, E. & Lorance, J. (2012). Physiological measures in art therapy evidence- based research. In C. Malchiodi, (Ed.), Art Therapy and Health Care. New York, NY: Guilford.   

Warson, E. (2012). Healing across cultures: Arts in healthcare with American Indian and Alaska Native cancer survivors. In C. Malchiodi, (Ed.), Art Therapy and Health Care. New York, NY: Guilford.   

Zaidel, D. W. (2014). Creativity, brain, and art: biological and neurological considerations. Frontiers in human neuroscience, 8, 389. 

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