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.
Part of healthy coping involves processing emotions. As physicians, we often distance emotions. That serves us well in times of emergency to stay focused. It is also helpful when we "check our countertransference" to avoid reacting poorly to patients in various forms of maladaptive behavior. Being able to emotionally regulate is important. But at some point, the really intense situations and emotions need to be dealt with healthily to head off negative consequences down the road.
So, what does “process an emotion” mean?” I had heard it but never really questioned what it meant until I had a particular resident who was causing a bit of disruption within her class, among the office staff, and even within our faculty. She was chronically anxious, on defense, and complaining. She would text attendings on their days off or late at night. She kept colleagues from focusing on work 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 know how to process the emotion. I realized at that point, I didn’t really understand what it meant practically. In case you are in the same boat, I will give you my approach to understanding.
There are four things you can do with any emotion. 1. You can react to the feeling. If you’re angry, you can yell. If you’re disgruntled, you can quit on the spot. 2. You can resist the emotion. Utilizing willpower, white-knuckling it, to prevent feeling it. This is like holding a beach ball underwater. Eventually, it's going to pop back up violently. 3. You can avoid/ignore your feelings by eating, drinking, gaming, scrolling, shopping, etc. (buffering or numbing). It is called “comfort food” for a reason – rather than feel sadness, let’s just eat ice cream and fries. This is similar to distancing the emotion as described in the opening of this blog. If you distance chronically, you blunt all emotions - even good emotions. Essentially, you constrict the aperture of emotions. 4. You can allow it or process it. Metabolize it, if you will.
Processing an emotion starts with naming it. Sometimes it's helpful to look at a list of feeling words to really zero in and label it. This is called affect-labeling. It, by itself, helps disarm the amygdala. Then, move to allow it to be present. Lean into it instead of trying to avoid it. After all, it's a sensation we feel in our bodies. We often read books, watch movies, go on amusement rides, or adrenaline-heightened adventures to experience those same emotions on purpose.
We spend so much time trying to avoid negative emotions, and, in the end, we end up with a net-negative outcome. If you are constantly yelling, quitting your job, or turning to food, it’s not hard to see in the long run that you are increasing suffering. Let’s learn to embrace the full human experience as roughly 50/50—about 50% pleasant and 50% unpleasant. You have great days, low-light days (as my friend Rita calls them), and everything in between. When we feel an unpleasant emotion and are not shocked by it, it allows the feeling to be present. There is no reason to avoid or react; you accept it. It’s just the expected less-pleasant half of the full human experience. Maybe you’re disappointed you weren’t asked to head up a project or be the chief. It’s okay – disappointment happens.
By allowing it to be present without judgment, then we move on to the processing piece. Emotions are felt somatically. As an example, being nervous often gives the feeling of butterflies in the stomach. When you recognize an emotion that you're tempted to avoid or react to, tune in instead. Where do you feel it – your head, chest, stomach? Does it feel fast like butterflies or heavy like a hammer falling? As you turn your focus to the body, the feeling can change location or character, stick with it and follow and examine it. Often within a couple of minutes, the intensity is eased, and it passes on. (If you notice new thoughts, it may fuel the feeling, try to bring your attention back to the body each time you begin to add new thoughts about the situation).
Sometimes emotions come back in waves; grief is notorious for this. It's normal. It’s okay– you recognize it, allow it without judgment, and focus on where it is in the body, and then it releases or passes through. Emotions are data. Try asking yourself if the emotion is a clue. You may unlock some thoughts that help move you forward. For instance, anger is sometimes a signal that a boundary has been crossed or that a boundary is needed. You can think through the details. Is it true? If so, how do you want to view the boundary break?
Stress happens; there are positive options to cope using both external and internal tools. You chose the 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 get on roller-coasters to feel those very same emotions).
Have a joy-filled week - Tonya
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