Understanding Emotions and Managing Them for Your Health

Introduction

We all know life is too short to stress ourselves over anything but still, we often experience stress. Why? Maybe because of our evolved emotional brains. Or maybe because of our personality. Or maybe due to some external unavoidable factors. Or we do not know how to handle our emotions. The answer can be many or any. If emotion-inducing stressful situations are an inevitable part of our life, then what do we have in our hands? The answer is its regulation.  

Emotions and Their Significance 

To understand emotion regulation, let us explain the meaning of emotions first. The term ‘emotion’ is difficult to define as it has been taken from an everyday discourse of people (Suri, Sheppes, & Gross, 2013). According to the dictionary of APA (American Psychological Association), emotions can be defined as, “a complex reaction pattern, involving experiential, behavioral, and physiological elements, by which an individual attempts to deal with a personally significant matter or event.” Thus, emotions consist of three key parts: one’s subjective experience of emotion, the physiological response of emotions, and behavioral response of emotions. 

Gross and Thompson (2007); the famous scholars in the field of psychology of emotions, also described three core components of emotions: 

(i) Appraisal of the situation: Emotional experience depends on the appraisal of the situation or stimuli and this appraisal depends on the process of attention and meaning assignment. Moreover, the meaning of a stimulus depends on one’s goal and if the goal changes in due course of time, the associated meaning of the stimulus also changes which leads to a change in the experience of emotions. 

(ii) Multimodal: It is a multi-faceted and whole-body phenomenon that involves changes not just at the level of subjective experience but also at the level of behavior and physiology (central and peripheral). 

(iii) Malleability: Emotions do not just influence other systems but other systems are equally capable of influencing emotions. It is this aspect of emotion which can be modulated or changed and thus most important for regulating emotions. 

Literature review on emotion suggests that it can play important roles at multiple levels. It can be a cause or/and consequence of a disease. In his pioneering book, “The deadly emotions”, Ernest Johnson (1990), proposed that anger, hostility, and aggression are responsible for several psychological problems such as depression and chronic stress. The negative consequences of emotions are not limited to psychological problems only but are also found to be an important cause of heart disease, ulcers, cancer, diabetes and hypertension. In the context of heart disease-a type of chronic disease, emotion regulation has been found to play a significant role not only in its development but also during the disease in determining illness outcome (Mauss & Gross, 2004). 

The presence of an illness specifically a chronic illness can also lead to the development of emotional problems like depression and anxiety in type 2 diabetes mellitus patients, which can affect the Quality of Life (QoL) of these patients (Nouwen et al., 2010). The presence of depression has been also found to affect the quality of life negatively in diabetics (Verma et al., 2010) as well as in normal populations (Arslan et. al., 2009). Similar results have been reported for other chronic diseases like cancer (Weinbergeret, Bruce, Roth, Breitbart, & Nelson, 2011; Cataldo, Jahan, & Pongquan, 2012) and arthritis (Covic et al., 2012; Matcham, Rayner, Steer, & Hotopf, 2013).   

Since emotions play a significant role in determining our well-being, an inability to regulate them could impact our mental and physical health both negatively. Existing scientific studies have positively identified emotional dysregulation as the cause of various psychological disorders and health issues (D’ Avanzato et al., 2013; Aldao, Nolen-Hoeksema, & Schweizer, 2010). 

On the other hand, successful regulation is associated with resilience against depression and anxiety in patients (Southwick et al., 2005). Therefore, it could be concluded that emotions improve as well as deteriorate one’s overall health depending upon how we manage them. 

Emotion Regulation

Thompson (1994), has defined emotion regulation as, “all the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one’s goal” (p. 27-28). Whereas Gross (1998) has defined it as “the processes by which individuals influence which emotions they have when they have them, and how they experience and express these emotions” (p. 275). However, it is important that the regulation of emotions should be in accordance with the demands of society as well as the need of the individual (Cole, Michel, and Teti, 1994). 

Although, there is no consensus among scholars on what should be called ‘emotion regulation, however, existing literature does recognise Cognitive Emotion Regulation Strategies (CERS) as a better way of regulating emotions than any non-cognitive ways (Gross, 1998). Cognitive emotion regulation can be defined as a set of those strategies that use cognitive faculties to regulate one’s emotions. Although there are various cognitive strategies, the literature identifies four maladaptive strategies (self-blame, rumination, catastrophizing and blaming others) and five adaptive strategies (cognitive reappraisal, acceptance, positive refocusing, refocus on planning, positive reappraisal and putting into perspective) (Gross, 2002; Garnefski et al., 2001). 

Out of all these cognitive emotion regulation strategies, cognitive reappraisal is widely studied and found to be the most effective strategy. It has been found to work as a buffer to anxiety, stress and depression for various illnesses (Karademas, Tsalikou and Tallarou (2011). It involves: recognising one’s negative emotional state and then reinterpreting the situation to reduce the severity of the negative response.

For example, if someone fails in any job interview and instead of feeling dishearten, he/she may view this failure as an opportunity to improve his/her skill. This indicates that the individual practices cognitive reappraisal techniques to deal with the resulting negative emotions. Similarly, in the context of health, if someone got diagnosed with diabetes then reappraising this emotion-inducing situation as an opportunity to improve one’s lifestyle, is another example of cognitive reappraisal.

All these re-appraisals of the above-mentioned situations are not based on purely irrational thoughts but also contain a kernel of truth. Being an effective way of regulating emotions, cognitive reappraisal plays wonders by reversing our emotions back to normal. Next time when you find yourself getting involved in an emotion-inducing situation, consider reappraising it using the following strategies:

● Try to see the other side of the situation 

● Try to have other’s perspective 

● Try to acknowledge, accept the situation and then respond instead of reacting

● Try to remember every experience teaches us something even the bad ones

● Try to focus on those aspects of any situation which you can control like your response, thoughts etc.

● Let those things go which are beyond your control like how others react, their attitude etc. 

● Try to remember that the effects of bad events are temporary

● Try to be open to every experience

● Engaging in positive self-talk

● Lastly, compassion and love go long way whether with others or with ourselves. 

The article is written by Prof. (Dr.) Arti Singh, Assistant Professor, Jindal School of Psychology & Counselling (JSPC)

References

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American Psychological Association (2022). Emotions. APA Dictionary of Psychology. https://dictionary.apa.org/emotion

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Johnson, E. H. (1990). The deadly emotions: The role of anger, hostility, and aggression in health and emotional well-being. Praeger Publishers.

Nouwen, A., Winkley, K., Twisk, J., Lloyd, C. E., Peyrot, M., Ismail, K., …& European Depression in Diabetes (EDID) Research Consortium. (2010). Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia, 53(12), 2480-2486. DOI: https://doi.org/10.1007/s00125-010-1874-x

Verma, S. K., Luo, N., Subramaniam, M., Sum, C. F., Stahl, D., Liow, P. H., & Chong, S. A. (2010). Impact of depression on health related quality of life in patients with diabetes. Annals Academy of Medicine Singapore, 39(12), 913. https://open-access.imh.com.sg/handle/123456789/4499

Arslan, G., Ayranci, U., Unsal, A., & Arslantas, D. (2009). Prevalence of depression, its correlates among students, and its effect on health-related quality of life in a Turkish university. Upsala journal of medical sciences, 114(3), 170-177.

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Mauss, I. B., & Gross, J., J. (2004). Emotion suppression and cardiovascular disease: Is hiding your feelings bad for your heart? In L. R. Temoshok, A. Vingerhoets, & I. Nyklicek (Eds.). The expression of emotion and health (62-81). London: Brunner-Routledge. 

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Karademas, E. C., Tsalikou, C., & Tallarou, M. C. (2011). The impact of emotion regulation and illness-focused coping strategies on the relation of illnessrelated negative emotions to subjective health. Journal of Health Psychology, 16(3), 510-519.

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