Episode 98: The Surprising Science of Mental Overload with Karen Geiger

Topics Covered

• The Brain Science Behind Writing and Mental Clarity
• How Writing Became a Tool for Healing and Resilience
• Why Writing by Hand Activates the Brain Differently
• How Writing Reduces Cognitive Load and Mental Overwhelm
• Brain Fog in Perimenopause and Menopause Explained
• Burnout, Medical Training, and the Loss of Empathy
• Using Storytelling and Creativity to Learn More Effectively
• The 5-Minute Writing Exercise That Helps You Hear Yourself Again
• The Power of Asking “Why Not?”

“Your brain is giving you hints. We just need to quiet down and listen.”

When my guest, Karen Geiger, said that during our conversation, I thought, “She gets it.”

If you’ve been feeling mentally overloaded, emotionally stretched thin, or wondering why your brain suddenly feels foggy and scattered, this conversation is going to feel like a deep exhale.

Today, we’re talking about writing for mental clarity, and how writing can help reduce cognitive overload. Karen blends brain science and therapeutic writing to help people process stress, burnout, and major life transitions.

And this conversation reaches far beyond writing itself, from stressed medical students trying to keep up to women navigating midlife changes, brain fog, and shifting identity.

You may walk away thinking differently about writing, and maybe even differently about yourself.

Find the full transcript and bonus resources for physician moms at inspiredmommds.com/98.

The Brain Science Behind Writing and Mental Clarity

Dr. Cindy: Hello, and welcome back to Inspired Mom MD's podcast. Today, I am joined by Karen Geiger, a speech language pathologist, therapeutic journaling facilitator, and book coach who is doing something really unique at the intersection of brain science, language, and storytelling.

Karen's work explores how the words we use don't just reflect how we think. They actually shape our cognitive load, our resilience, and our ability to move through high-stress periods of life. She blends speech language pathology, cognitive neuroscience, and structured writing techniques to help people navigate transitions like burnout and grief, and even the identity shifts that come with perimenopause and menopause.

She's also a speaker on the research behind journaling for brain fog and mental clarity, and she's created programs supporting both physicians and medical students, especially at a time when resilience and empathy are slowly declining.

First, I want to welcome you to the show. I'm so excited that we can talk today.

Karen: Thank you so much, and thank you for having me. I am really excited to talk to your audience.

Dr. Cindy: Oh, yeah. They are going to learn so much. I'm really excited about these topics that I briefly skimmed over. Now let's dive into them a little deeper.

Karen: It sounds like a lot.

Dr. Cindy: It does, but no, we'll make it really clear.

How Writing Became a Tool for Healing and Resilience

Dr. Cindy: Okay. So first, let's just start with your story. You have training in speech language pathology. How did that evolve into journaling and narrative work?

Karen: Sure. Well, my first love was always language and writing. So I was an English major undergrad and, you know, then quickly realized I don't know what this can become, except for maybe a teacher or a full-time writer, which I didn't really wanna do at the time.

So I went to graduate school for communication disorders because I felt like that was a really nice link. And I graduated, you know, with my master's in that and always worked in rehab and acute care and a little bit in nursing homes. And then- As my kids, I stayed home, raised my kids. As they started to leave the nest, it was a little bit of, "Now what am I gonna do?"

I wanted to return to that creative spark that I had, and I had always delved a little bit into writing, just for me, nothing for anybody else's eyes. And I'm one of those people that I wanna see what's going on behind the scenes. And I thought, well, I'm gonna take a book coaching course, because I wanna see exactly how a book is supposed to be made.

What are the ins and outs? What are the plot lines, the structure, the must-haves? And so while I was taking that course, and it was extensive. It's through the Author Accelerator Program, so it's no joke. I mean, it's not like a weekend thing. It was a year. At that same time, my girlfriend started the Erie Cancer Wellness Center, and it is a center for individuals who are dealing with or have loved ones who are dealing with cancer.

And it is all free mostly, you know, free of charge, and it's the things that's not chemo and radiation. It's not physicians. It is yoga, writing, reiki, grief groups, support groups, art therapy, all of those ancillary services that make you feel like you still have a full life while you're going through something extremely difficult.

And so my friend said, "You know, I know you'll be able to do this because you're an excellent writer," which I was obviously like, "Okay, thanks. Thanks for the vote of confidence," but also the medical aspect of it. But I didn't know what that looked like. You know? I had to make sure that it was legitimate because these people were coming in for help, for healing through writing.

And so that's when I went, and at the same time as my book coaching, I went through and got a certification in therapeutic journaling through the Journal to the Self program. And that is a fantastic program that offers a little more than 15 techniques to approach a blank page. And so I'm still teaching there pretty much once a week off and on.

I have a curriculum there. And that's how I started to kind of expand and take my cognitive rehab, my love for language, and then add in the writing and the journaling. Such a long answer.

Dr. Cindy: No, no, that's a great background. You have extensive training, number one, but also it's based in science, and I think that that's going to come through today.

Karen: It is. So everything, and I hope that that definitely comes through, because I really believe that everything has to be grounded in science and education. This isn't stuff that I'm making up.

You know, this is… Which unfortunately sometimes in today's world, you don't know what to believe and you don't know what's true.

And, I am not AI. This is, you'll notice with all of the mistakes I make that I am not AI. And, you know, this is grounded in really great scientific literature, so it's all backed up, and so that's what makes it even more real and concrete for me.

Dr. Cindy: Speaking of science, let's talk about the brain science.

Karen: Sure

Why Writing by Hand Activates the Brain Differently

Dr. Cindy: Can you explain what is happening in the brain when we write?

Karen: Yes. So the first thing I want to say is when I instruct journaling, and I always say journaling with a pen to paper is optimal. If that's not possible for you, then please type. If typing isn't possible, then please speak into your phone.

It's better to have something than nothing. Like, I don't ever want anybody to think, "Well, I can't write on a piece of paper. That doesn't work for me for some reason, so I guess I just won't journal."

Hand to paper, pen to paper does activate different neural connections in your brain.

And so really when you think about it, when you are writing, you're using the language centers, right? You're using your left temporal parietal, Broca's area, Wernicke's area, and so you're formulating all of those words. You're trying to figure out which words, you're gathering the words that you want to use.

Then we're organizing those, so that's a different part of the brain. We're organizing. We're sequencing them. We are putting them in the, like, priority. You know, what do we wanna do first? And then we're translating all of that in fine motor skill to our hand. And so we are just activating so many different areas of the brain just by writing.

In fact, there is research that shows that when students want to remember something, when they write the notes or when they recap even, anything that is on pen to paper, that they are more likely to remember it, which is really a shame because pretty much everything is done on iPads and computers, and they don't really write that often.

Dr. Cindy: So you bring up a couple good points. First, yes, when I was in med school, I wrote out my big cheat sheets- Right … pen to paper, or pencil to paper.

How Writing Reduces Cognitive Load and Mental Overwhelm

Dr. Cindy: But also, I'm thinking about what you said a few minutes ago, that you are not AI, and a lot of people offload all of these things and processes that are happening in our brain to AI.

It's like dumping off this work onto AI. But at the same time, something you said to me the other day is really interesting, that you said structured writing reduces cognitive load. So the- Yeah … so you can offload to AI to reduce your cognitive load, but also writing can reduce cognitive load.

Can you explain that portion of it to me?

Karen: Sure. And I think, you know, with the AI, I'm not 100% against it. I mean- Yeah … I will tell you, I love Perplexity. I mean, that is such a great tool for finding the science and finding actual resources.

But when we give our authority and our agency to a computer and we say, "Hey, write this for me," or, "Organize this for me," we are actually kind of telling our brain, "Oh, you're not able to do that. You don't have the capability."

And we're also not working our brains. We're just letting, you know, we're just kind of… I don't wanna say lazy, because that's not the right word, but we're just allowing ourselves to hand that over. So with the cognitive load, we have, I believe it's between 50 and 70,000 thoughts a day. And, you know, how 90% of them are the same thoughts that we had yesterday. We are on this perpetual, habitual loop of thoughts.

The cognitive offloading is probably my favorite technique because it's super easy, and it's what I start every med school class with. So it was interesting. When I first started teaching there, and I'll tell you what this is, but, you know, the students are overwhelmed.

This is the first time they've sat in a medical school, in their chairs with, you know, their desks and the computers, and they've already studied three hours of anatomy or biochemistry or whatever it was in the morning, and then I come along, and they're like, "Oh my God.I just wanna go home and study."

And the very first thing I say is, "Put everything away. Put your computer away. Put your phone away. We're gonna do some cognitive offloading."

And I lead them in a very very short meditation of locating, identifying, and noticing what comes up in their brain. What's going on? What are you thinking about? And then having them- In no order. This isn't prose, this isn't pretty. Just dump it out.

We can call it a brain dump. I like cognitive offloading, because it's really just that we're taking all of our extensive thoughts, all of the things that are swirling around and spiraling, and things we might be perseverating on, you know, like, "I don't wanna be here. I don't wanna be here," you know? And putting it on the page.

And then we get to look at it, and we get to decide if it's true, if it's important, if we can cross things off, or we just get to look at it and go, "Yeah, that's a lot. That is a lot of information, and I don't have to think about that right now. That's out of my head."

It's tangible. It's concrete. It is visible.

So that allows them to give me, maybe 40 minutes of, "I don't have to worry about that." And it also helps because maybe by the second or third day, when they are truly frazzled with, "Oh my gosh, I am not gonna be able to remember all of the, you know, muscle innervations," whatever they happen to be on, I tell them, "What was your lecture about this morning? Think of everything that the professor said, and write it out."

And it surprises them. It surprises them with how much they paid attention, or maybe how much they didn't. And so again, it's out of their head, but it's also a form of recall. So we're really utilizing our brains for more than just storing things.

It's a strategy, you know? The pen and the paper are a strategy for making our brains work even better for us.

Dr. Cindy: And perhaps a new strategy for some, for the younger generation.

Karen: Yes. And I will say, by the second day, they saw me coming, and they just packed up all their stuff, and they were sitting there, like, just waiting.

I think they were, you know- Wow … they were already anxious for a little bit of downtime. Some of them, anyway. I chose to look at the ones who were ready.

Dr. Cindy: I love… and I, yes, I'll come back to the medical students

Karen: Okay …

Dr. Cindy: in a minute for sure. But I, whoo, there's so much to talk about.

But I do want to talk about briefly- … menopause and perimenopause- … and brain fog, because this is another area of interest for you. What does the research show?

Brain Fog in Perimenopause and Menopause Explained

Karen: Yeah. So I actually work within Dr. Heather Hirsch's, she is a menopause physician, and I work within her concierge medicine practice and her collaborative.

And I've spoken on stages at menopause conferences, and it's really interesting because when Dr. Mosconi came out with her research- Last year maybe, a year and a half ago, saying that, hey, you know, the estrogen isn't just in your reproductive system. It's all over. You know, it's in your joints. It's in your brain.

And so as estrogen declines, she really attributed the brain fog, those brain fog moments, the "why did I walk into this room," you know, which we've all had. It's like "What, what was I saying?"

I have friends who have stopped mid-sentence, and it's like, yeah, I get it. Don't worry about it. It'll come back to you. I think it's roughly 40 to 50% of women report that they experience some kind of brain fog. You know, usually I think the first symptom or that is, or the most rated symptom is the hot flashes.

And then we have the brain fog and memory loss and word retrieval issues, and, a lot of women, it's interesting, a lot of women are like, "I think I have ADHD."

And they could, but it could also just be that loss of estrogen. And I think that it's a little bit of a narrative, it's a little bit of an identity crisis because we are, it's kind of like sandwiched just right with, you know, maybe we are changing careers. Maybe we're ending a career. Maybe if you had kids, they're leaving.

And it is the most prominent question that I get in my classes is, "What's next? What, what am I supposed to do now? Like, it's… It is like, well, my life is changing. My identity is changing because of that, and now what the heck is happening to my body?"

And it's uncomfortable, and so we don't recognize a lot of things. We don't recognize that who we once were, and we were very fluent and we could talk, and, you know, maybe you were giving presentations at work, and it's like all of a sudden you're like, "I have no idea what I'm doing. I'm not organized. Words are like, oh, I'm at a loss for words, literally."

And so the journaling that I teach is really strategic, and so it is structure, and it is intentional.

And with the therapeutic journaling techniques that I couple those with the cognitive rehab, and the techniques target different areas of the brain. You know, sometimes there's a little bit of an artistic technique or tool, and then a lot of them are really focusing on the prefrontal cortex, which is that, organizing, prioritizing, categorizing, problem-solving, focusing, paying attention to task, being able to initiate a task, which a lot of times menopause tends to kind of put like a wet blanket on that.

And so the tools that we use, the prompts that I use are specifically designed to target those areas, and it's kind of like lifting weights. I like to call journaling the weighted vest for the brain. We're using it. It's kind of like use it or lose it, and so we need to keep using it.

And obviously, it's not the whole factor, you know? I mean, we have hormone replacement. We have making sure that your healthy lifestyle, and part of the healthy lifestyle is also stress reduction. And journaling is proven to increase mindfulness, decrease stress, and is also proven to decrease cortisol.

So, I feel like it’s almost a no-brainer to say give it a shot.

Dr. Cindy: Yeah. It sounds like a breath of fresh air. That’s what comes to me.

Karen: It’s, it’s not a bowl of cottage cheese, and it’s -…not, you know, I don’t talk about anything that’s not writing. There’s no protein. I don’t dive into what’s not my area of expertise.

So this is just, it's just a little, it's a different avenue.

Dr. Cindy: Right. It's complementary.

Karen: Yes …

Dr. Cindy: It reminds me of what you were just talking about with the patients with cancer. It's all of the other things that help them feel human-

Karen: Yes.

Dr. Cindy: … outside of the medicine. Yeah. Mm. Okay. I do want to get back to medical training and burnout.

Burnout, Medical Training, and the Loss of Empathy