What the Heck Does it Mean to Process an Emotion? --Coping in the World of Medicine: Part 3

This week we will conclude our series on coping. The first week, we discussed some positive external methods to cope, along with a list of resources.  Last week, we discussed internal mechanisms of coping.  And finally, we tackle the cliff-hanger of sitting with your emotion and processing it. 

What the heck does it mean to process emotions anyway?

This week we’ll conclude our series on coping.
The first week, we talked about some positive external ways to cope, along with a list of resources.
Last week, we looked at internal mechanisms of coping.
And now, we tackle the cliff-hanger of sitting with your emotion and processing it.

Why processing emotions matters

Part of healthy coping involves processing emotions.
As physicians, we often distance emotions, and that serves us well in emergencies when we need to stay focused.
It’s also helpful when we “check our countertransference” to avoid reacting poorly to patients or colleagues.
Being able to regulate emotionally is important.
But at some point, the really intense situations and emotions need to be dealt with in a healthy way to head off negative consequences down the road.

When I realized I didn’t actually know what it meant

So, what does process an emotion even mean?
I’d heard the phrase but never really questioned it until I had a particular resident who was causing disruption in her class, among the office staff, and even within our faculty.

She was chronically anxious, defensive, and complaining. She’d text attendings on their days off or late at night. She kept colleagues from focusing because she monopolized their time to vent.

In a meeting with the resident, one of our behavioral faculty said she needed to learn to “sit in her anxiety” rather than react. In other words, she needed to process the emotion.
I realized I didn’t really understand what that meant practically.
In case you’re in the same boat, here’s my approach after doing some work to understanding it fully.

How do you process emotions?

There are four things you can do with any emotion:

1. React to it.
   If you’re angry, you can yell. If you’re disgruntled, you quit on the spot.

2. Resist it.
   Using willpower or “white-knuckling” to keep from feeling it. That’s like holding a beach ball underwater. Eventually it pops up violently and splashes everyone.

3. Avoid or ignore it or numb.
   Eat, drink, scroll, shop, work, or game instead. “Comfort food” is named so for a reason.
   Chronic distancing dulls all emotions, even the good ones. You can’t selectively numb emotions. It’s like the camera aperture, the entire impact of emotions shrink, including experiencing joy. 

4. Allow or process it.
   This is where the real work happens. You can think of it as metabolizing it rather than the other 3 choices. The emotion gets to “pass through.”

Step 1: Name it

Processing starts with naming the emotion.
That’s called affect labeling, and it alone helps calm the amygdala.
Physicians aren’t known for their wide emotional vocabulary. 😉 So you may want to use the Feeling Wheel or Mood Meter App.

Step 2: Allow it

Next, move to allow it to be present. Lean in instead of trying to avoid it.
It’s just a sensation in the body. That’s it. You’ve survived every emotion you’ve ever had.
We even seek out emotions when we read novels, watch movies, or ride roller coasters to experience them on purpose, so why not allow them in real life?

Step 3: Embrace the 50/50 of life

We spend so much time trying to avoid unpleasant emotions that we create a net-negative outcome.
If you’re constantly yelling, quitting, white-knucking and splashing everyone, or turning to food and shrinking your aperature, you’re increasing suffering.
Instead, embrace the full human experience, roughly 50/50 pleasant and unpleasant.

You’ll have great days, low-light days (as my friend Rita says), and everything in between.
When you stop being surprised by the unpleasant ones, you allow them to exist without resistance or judgment.
It’s just the less-pleasant half of being human.
Maybe you’re disappointed you weren’t asked to lead a project. It’s okay, disappointment happens.

Step 4: Tune into your body

Emotions are felt somatically.
Being nervous often feels like butterflies in the stomach.
When you notice an emotion you want to avoid, tune in instead. 

Like and HPI: Where do you feel it - your head, chest, stomach?
Does it feel fast like butterflies or slow? Excitement is fast. Anxiety is fast. Contentment is slow. Sadness is slow. 
Light like helium or heavy like a hammer?
Stay curious. Follow it. Notice if it shifts or changes.
Usually within a couple of minutes, the intensity eases and passes. Rarely does it last beyond 90 seconds if you give it the attention it needs. Like a toddler pulling at your pants leg, it’s likely to get louder if you don’t give it the attention.

If new thoughts pop in, they’ll fuel the feeling longer.
Just notice them and gently bring your focus back to the body.

When emotions come in waves

Sometimes emotions return in waves. Grief is famous for this.
It’s normal.
Recognize it, allow it without judgment, focus on where you feel it, and it will release again.

Emotions are data.
Ask what clue the emotion is signaling:
Is anger telling you a boundary was crossed?
If so, what needs to change?

Bringing it all together

Stress happens.
You have both external and internal ways to cope. Choose what fits best for you.
One of the most powerful tools is not being afraid of any emotion.
It’s just a feeling in the body that eases when you pay attention to it.

After all, many of us read books, watch movies, or ride roller coasters to feel those same emotions on purpose.

Next up: The Challenge of Emotions in Medicine — how these ideas show up in everyday clinical life. I also discuss guilt, and whether it's adaptive or not, that we learn in training. Read: Guilt as a Resident Physician.

Have a joy-filled week,
Tonya

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