Out, damned emotions! Out

Lately I’ve been having multiple conversations with clients who want to ‘scrub out’ some aspect of their emotions:

‘I just wish I wasn’t so emotional’

‘How do I stop being so emotional?’

Of course, they mean emotions related to being upset or angry about something. Have you ever heard someone lament their sense of humour, or experience of joy?

Didn’t think so.

Now, I’m no Lady Macbeth – but I’ve had my own moments of wishing away big emotions. Times when I’ve thought I’m been too emotional. I’ve invested considerable time and energy in trying to ‘scrub out’ certain emotions and come to the conclusion that nothing works to get rid of unwanted emotions.

We can reframe them, numb them, drown them out, suppress them. But we can’t really get rid of them in a sustainable way.

That’s not to say that we should let our emotions get the better of us. That we become beholden to any moment of anger or sadness or hurt.

Clearly we need to find a way to notice, listen to and harness our emotions so we act in an appropriate way. In other words, what we really mean by not being emotional is getting better skills in emotional regulation. In being able to hold uncomfortable emotions and manage them in a way that is appropriate for context.

This type of emotional regulation is what we talk about when clients they say they wish they weren’t so emotional – and we certainly work on building skills in this.

However, we do live in a world that aims for happiness. As such we judge harshly anyone experiencing ‘negative’ emotions – and we also judge ourselves.

We tell people in myriads of ways to get their emotions under control. We feel people displaying emotion are weak and ‘hysterical’. We want people to deal with emotions in their own time and not bring it to work. We judge emotional people and patients as ‘touchy’, ‘difficult’ or ‘heartsink’.

Yes I get it. There is a time and a place. But does this pervasive negative attitude toward emotion say something more about us, about our fears of discomfort than anything else? Is this kind of implied emotional suppression even healthy?

A different view of emotions

Emotions are a very special and important part of being human. They enrich life and provide useful information about the world.

As doctors we work in an emotion filled space of fear, anger and sadness. People sometimes die despite everyone’s best efforts. Some people suffer life altering injuries and illnesses. There’s lots of unpleasant emotions in the atmosphere.

We are often taught subliminally that ’emotions’ are ‘bad’. That we need to stay professional and cool headed. That letting emotions in will cloud our judgement – or at best make us look weak. That to feel the emotions around us will result in compassion fatigue and burnout.

It’s certainly seems to smooth things along in the short term if we can stay in our heads and not in our hearts. But in the long term I think this persistent disengagement from emotion does weird things.

We get out of tune with our own experience of the world. We get out of tune with our experience of distress, tiredness, fatigue and burnout. I’ve had doctors tell me they had no idea how distressed they were until a crisis happened – or they did a K10 test out of curiosity.

And if this pushing away and suppressing of emotions does weird and unhealthy things to us, then it also, inevitably gets in the way of the doctor-patient relationship founded on empathy and trust. It’s true we can experience a type of cognitive empathy, but this is not the same as healing force of ‘feeling with’ that empathy implies.

My feeling is we need to absolutely stay in touch with our emotions. We feel what we feel. It’s their expression and how we act in response to an emotion – ie emotional regulation – that is the really important thing here. Shutting them out of the way and denying them their voice doesn’t help.

Getting a better handle on emotions

Emotional regulation is the name of the game here – but of course it’s not always easy to do. Here’s just a few of the strategies I have learned and work with doctors to achieve better emotional regulation:

**Noticing and naming emotions – they will be heard one way or the other

**Listening to the message of the emotion – what does it tell you about the way you are making meaning in a given situation and how can you use that information to get better self-insight and enact change eg in a given tough and tense interpersonal situation:

  • Am I seeing myself as a victim?
  • Am I seeing the situation as an unavoidable outcome of system forces?
  • Am I seeing the situation as an opportunity for something to learn from?

**Developing strategies to get space from the emotion in order to allow space for constructive thought eg breathing and relaxation exercises, mindfulness etc

**Developing strategies to reduce baseline level of stress eg general self care strategies, exercise, sleep, diet, relaxation etc

**Seeking appropriate professional support in the form of mentoring, peer support, Balint groups, clinical supervision or coaching in learning to better manage ‘negative’ emotions and their impact.

Bottom line: emotional regulation is a lot more sophisticated than ‘being less emotional’. It’s also a lot more challenging to achieve on your own. They say two heads are better than one – and in the field of emotional regulation it often comes down to two hearts.

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