Emotions 101

Emotions: What Are They?

What do you think of when you read the word “emotions”? What comes up for you? For many, this brings up mixed feelings. Many people chase emotions that feel good to them: happiness, joy, excitement. And that makes sense. We are conditioned to believe that feeling good is of utmost importance. And I’m not arguing against that by any means. However, the flipside of that coin – that feeling good is the ultimate goal – is that feeling bad is something to be avoided. Negative feelings like sadness, anger, frustration are to be avoided and if they come up - quick! Push them away!

This reaction to negative emotions is understandable in many ways. First, in many ways we’re trained not to express our emotions. When we’re young children, just learning to regulate our own emotions, we are commonly told by parents, teachers, and other well-meaning caregivers, “Don’t cry,” “Don’t be sad,” “Stop being angry,” and so on. These caregivers are likely motivated by two goals. First, stop the emotion if possible because it hurts the caregiver to see his or her child in a difficult emotional state. And, second, at least educate the child in how to behave differently from how their emotion is telling them to behave. So, if the child is angry, teach the child that hitting is not an OK response to anger. Learning to respond in a calm manner to your emotions is essential to developing into a socially functioning adult; however, it does not have to require that we learn to push away our emotions.

As part of this education, we don’t learn how to truly tolerate the negative emotions that are a natural part of being a human being. We learn a lot of strategies that can be effective at removing us from the emotion, but often only in the short-term. Some strategies that are pretty common are reacting to the source of frustration or anger (flipping the bird in traffic, yelling, slamming doors), seeking social support (venting, seeking advice), or distracting (watching lots of TV, sleeping excessively, drinking, using drugs).

Chances are, you’ve used all or some of these to deal with a difficult emotion in the past. We all have. It’s not necessarily a bad thing to revert to a quick-reaction strategy in the heat of the moment. However, the choice of strategy is important (nap vs. drugs?) and the frequency of your use of the strategy is important. Also, it’s important to consider the consequences of your choice of strategy. Does flipping that other driver off really get you to your destination faster? Does slamming the door really fill in significant other on your perspective? I may be biased, but I’m leaning towards no.

So all in all, we’ve learned that negative emotions are bad and that we should get away from them as fast as possible. We learned through role modeling or experience that different strategies help to distract or numb the pain, but oftentimes those strategies only work in the short-term. So what is there to do in the long-term? First, we have to re-learn what emotions are.

Emotions are reactions to some kind of internal event. An internal event is something like a thought, memory, or physical sensation. Many people believe that things out in the world make them feel difficult emotions. However, if we slowwww that process down a little we can see that it really is interpretation of external events that produce the emotion. For example, let’s say you are waiting in line at the DMV. You see a little, old lady with a walker who resembles your great aunt Margerie slowly amble up the line and cut in front of everyone else. How do you feel as you witness that?

Now, let’s change the scenario. You are waiting in line at the DMV and you see a young kid that seems to be a walking embodiment of entitlement cut right in front of everybody else. How do you feel about that?

Chances are you may have felt a little bit of a difference between those two scenarios. Let’s say for the sake of argument that you felt slightly less indignant and angry when the little, old lady cut in front of you. Why do you think that is? Probably because the different features of the situation changed the context for you, which means that you interpreted the external event differently! So, if the situation is line cutting, but the person is a little, old lady, your interpretation leans you towards a softer reaction, such as giving her the benefit of the doubt, assuming she is hurrying because she can’t be on her feet, or just appreciating that she’s a cooky old broad who gets what she wants. In contrast, when that young, entitled kid cut in front of you, chances are your interpretation wasn’t so forgiving. The whole purpose of this example is to show that it’s not external events that make you upset. Nearly all of the time, it’s your interpretation of the event that is the true cause of your emotions.*

Now, that’s not to say that your interpretation and the resultant emotions are not valid. Every feeling you have is 100% valid. One of the difficult spots we get in with emotions is deciding that it’s not OK or appropriate to feel a certain way. However, I stand on the side of your emotions – every emotion you have is perfectly valid and understandable as long as the interpretation underlying it is accessible. One of the tricky things with understanding our emotions is that they often are experienced in layers. Emotions can be divided into two separate categories: Primary and Secondary.

Primary emotions are the first knee-jerk reaction that you have to your interpretation of an event. They usually are very powerful and don’t necessarily stick around for a long period of time. Secondary emotions are the emotional reactions to your primary emotions. They are more likely to hang around for a while, especially if we rehearse our interpretation and story around the external event (such as through venting to others, etc.). For example, imagine that you are watching your significant other chat to an attractive person at a party. Seeing this taps into some

not-so-helpful beliefs buried deep in your mind that lead you to interpret this scene in a threatening way. In response to this interpretation, you immediately feel insecure and scared that you’re going to lose your significant other to this sudden source of competition. These feelings are powerful and hugely uncomfortable. Almost immediately the secondary emotions will show up to try to protect you. Anger and jealousy will pop up and completely cover the tracks of fear because your mind believes those emotions are safer to feel. Then, in interacting with your significant other, chances are you will operate from this secondary level, whether through straightforward, aggressive, or passive-aggressive means. However, the true source of the entire emotional reaction, the fear, will not necessarily be addressed by operating only at the secondary level of emotions.

When working with patients I like to describe primary and secondary emotions like the roots and leaves of a weed. The primary emotions, the root of the reaction, are buried deep in thought processes and emotional experiences that happen so quickly, they’re like dark soil that can be difficult to dig through. The secondary emotions, the weeds, pop up and are so visible and tangible that it’s almost impossible to not react from this place. However, if we don’t address this entire reaction and interpretation at the root-level, the weed will just pop up again in a different context.

Phew. OK. That is a lot of information so far! Let’s pause here and let this simmer for a bit. What questions come up as you read this? What makes sense and what doesn’t make sense so far? Have you noticed a difference in your own experience of primary and secondary emotions? Fill me in!

*Certain external events may cause strong feelings without much accessible interpretation because of hardwired biological underpinnings. So, if you see someone badly injured or other traumatic experience, your emotional reaction may be less related to your interpretation and more hardwired.

Introduction

Hey there! 

 

Welcome to my blog! 

I'd like to take this space to share with you important information about health psychology. Psychology has been largely forgotten in the health care industry as we, as a society, have gathered more and more information about how to be healthy. Through clinical research and experience we've learned massively important things like, hydrogenated fats are not so good for us, and hey, exercise helps us feel better! And that information gets increasingly detailed and specific each and every day. If you look for it, you can get minutely-detailed information in just about every health concern in the books. Health concerns go through their own fads, which may or may not help the general population. For example, gluten-free is one of the newer food trends. This may lead to those with celiac disease to learn about their condition earlier. However, for others, it also comes with the cost of people potentially wasting unnecessary money and time on medical testing and specialized foods when it is not truly necessary. All of this information can come at a cost, and I believe one of the major costs is that it places excessive importance on the IMPORTANCE OF INFORMATION.

We are an information-driven society. We learn and learn and grow and grow, at an ever increasing exponential rate. However, all of that information we've gathered hasn't fixed us. Why do you think that is? There are a number of ways that people like to approach this question, from blaming the food industry, to blaming our industrialized, sedentary work habits, to blaming our "built environments," or the way we create our neighborhoods and cities to favor driving rather than more active forms of transportation. And, yes, I agree with these arguments. Each of these concerns is an important contributor to our current situation. However, these facts don't capture a hugely essential piece of the health puzzle that has sat silently in the wings for far too long.

Along with all of this information is a pure fact: WE'RE HUMAN BEINGS! Our society conditions us to favor left-brained, analytical, rule-bound, nearly robotic behavior. We see success as obtainable through hard work and difficulties often resultant from laziness and character flaws. Our media glorifies those who, through genetic and lifestyle advantages (as well as plastic surgery and photoshopping!), physically represent an ideal of being care-free, popular, valued, and abundant. We see negative emotions as things to push away, run from, and fix, rather than as signs and signals of our true experience. All of this conditioning has taken the human being out of health. I've had countless experiences with patients confused, frustrated, or both over recommendations they received from a physician about how to take care of their health. "Lose weight." "Exercise." These recommendations often pack a heavy punch and are delivered abruptly and within the span of 5 minutes.

Brian Regan, an amazing comedian, captures a standard adult doctor visit experience in one of his great jokes. If you haven't heard of him, I suggest you look him up. Laughter is wonderful for health, and while I get a kick out of crude humor, too, Brian Regan is immensely creative in that he is hilarious while also being respectful and PG-rated. Here's what he has to say about doctor visits:

"I gotta lay off the dairy. That's what my doctor threw in as I was leaving his office: 'Oh, and lay off dairy!' I'm like, 'what the?! What kind of blanket sweep is that?!' 'Lay off dairy!' He should have just said, 'And no more happiness!' I'm in the supermarket with my cart and I'm trying to avoid the dairy aisle... I can see they all have party hats over there..."

Now, this is not to blame doctors. Our health care industry is in a tight spot. The average visit with a primary care doctor (what most people consider the "regular" doctor) lasts 10.7 minutes (1). Fifty-one percent of doctor's visits involve zero health education services. The top most commonly provided health education is in diet and nutrition (14.8%) and exercise (8.5%) (2). However, only 25.6% of doctor visits involve no medication prescription. That means that instead of providing health education, we're providing meds. With little instruction. What I also know is that you want to be healthy. The number 1 reason why people visit doctors is for preventative check-ups. However 55% of people visiting the doctor have at least one chronic condition (2).

What this all really means is that this system is setting us up to be confused, clueless, and medicated.  

And may be a bit demoralized.

Folks like Brian Regan, who can bring our attention to our difficult current situation in terms of our health while making us laugh, are really helpful. What all of this means is that many people go in to the doctor and leave with a bunch of unanswered questions because they might not truly understand what they're experiencing and what they can do about it. Even a disease such as diabetes, which is growing steadily in our society despite it being highly preventable, is so extremely multi-faceted that it takes a highly dedicated patient a lot of time and energy to truly understand how to treat or even reverse the disease. Without the knowledge and motivation to move forward on learning these things, notwithstanding overcoming any potential fear they may have about their diagnosis and prognosis, many continue moving blindly forward alongside their health status.

However, taking care of your health doesn't have to be hard. It doesn't have to be confusing. It doesn't have to be insurmountable! But, taking care of your health does mean that we all need to acknowledge that we're all human beings. We're not robots. I'll repeat that. You are not a robot. When someone gives you a rule like, "lay off dairy," it doesn't work instantaneously, and it very well may not work at all. Doctors are part of the information industry: they are an important piece of the health industry mission to tell people information about their health status and how to improve it. Dieticians, personal trainers, and the like all fit into this puzzle. Everyone is working together to give you more and more information. However, this information is expensive and time-consuming and, on its own, may be unhelpful. I'm here to give you a new piece of the puzzle. It's partly information, but what it is really is a reflection and acknowledgement of what it means to be human in the health care industry. Where does human nature fit into this puzzle and how can we work with human nature instead of against it?

In this blog, I will go through plenty of information, but I've designed it according to subject so that you can read through it straight, or you can use it to look into specific topics as needed. This information is meant to be decidely non-robotic. I’d like you to be sure to read the next chapter on Emotions prior to doing anything else. Emotions are the keystone to achieving optimal health and I’d like to start selling you how great your emotions are before you go onto anything else.

 On board? Great. More to come!

References

1. Gottschalk A, Flocke SA. Time spent in face-to-face patient care and work outside the examination room. Annals of Family Medicine. 2005;3:488-93.

2. Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Survey: 2010 Outpatient Department Summary Tables.