Set Your Emotional Thermostat

The voice over the hospital intercom said, “Code blue.  830 East.”

I was a wet-behind-the-ears medical student new to the hospital wards.  My own heart pounded as I raced up the stairs to the cardiac arrest. By the time I arrived,  the room was a sea of white coats.

I stood next to my teaching resident leaning against the wall.  He looked at me and  asked, “What’s the very first thing you do when you arrive at a code?”

My thoughts raced.

He said, “First, take your own pulse.”

When you respond to a loved one in pain, it can feel like an emergency.  You are in the best position to help if you keep the calm rather than catch the chaos.

Here are three things to know as you translate this idea into action.

1. Emotions drive motion.  Your emotions are like your own GPS system that serve you in two ways.

First, emotions offer information about what’s happening in the outer world.  Sadness, for example, tells you that you lost something important.  Anger tells you that your needs are not being met.

Second, emotions shape the way you see yourself and others to best respond to the  outer world.  When you’re sad after a breakup, for example, you’re more likely to see  your ex for who they really are.

2.  “I feel your pain.” We humans are wired to connect.  A specialized set of brain cells called “mirror neurons” fire when we watch someone reaching for a ball as if we were doing it ourselves.  They allow us to watch others as if we were looking in the mirror.

Mirror neurons help us feel what others feel.  We can feel what others feel.  The more mirror neurons activated, the greater the empathy.

Professional distance may well involve the practice of unplugging mirror neurons.  This is like walking around your house covering the mirrors.

When mirror neurons are activated, you’re more likely to make choices with your feeling brain –or reptile brain.  Professional distance allows you to make choices with your thinking brain.

3.  Keep the calm rather than catch the chaos.  Pain activates the fight or flight system, activating fear and anxiety.  These emotions come in handy when you’re running from a saber tooth tiger.

You make the best choices about chronic pain management with your thinking brain.  Calm allows you to get there.   The leaders of dog packs –and human organizations–project calm.

The goal is for your loved one in pain catches your calm–rather than your catching their chaos. 

High emotional intelligence–the ability to read and regulate your emotions–predicts  personal and professional success.

The brain in pain 

Imagine burning your hand on a hot stove.  You quickly withdraw your hand, even before you feel any pain.  Right away you feel an acute searing pain.  The next morning, you feel a dull  pain that improves over time.

Different parts of the nervous system regulate the three stages of your response and recovery.  A spinal reflect pulls your hand from the heat, the signals do not need to go to the brain.

The searing pain travels along fast nerves that have a myelin sheath.  The signals end in the reptile brain. The achy pain travels along slower nerves that end in two parts of the brain–the reptile brain and the feeling brain.

All chronic pain has an emotional component.  Fear and anxiety increase the intensity of chronic pain; joy and love make the pain better.

A few months after her breast cancer diagnosis my friend Suzy was in a state of panic.  She had just opened her mail before she got in the car, and found a medical bill for several thousand dollars for her genetic testing.  As we drove together she was fretting about how she would pay it.

I know Suzy well; the thing that keeps Suzy up at night is the worry about how to pay her bills.

I said to her calmly, “Suzy, I was with you when you got the counseling for this test.  They said that they would call you if your out-of-pocket expense was more than $200.  This bill is just a simple error.”

It’s as if Suzy had not heard what I said.  “Maybe I’ll put it on the credit card, and pay it off over 6 months. “  I spoke with a louder voice, “Suzy, you don’t have to worry about paying it.  This is a clerical error.”  That just turned up her volume. By the end of the car ride both of us were upset.

Suzy finally did get to calm, despite my actions.  I made two mistakes I hope you can learn from.

The first mistake is my failure to address her emotional state.  My initial comment– “Don’t worry”– was not helpful.  I was dismissing her fear rather than acknowledging it.  The second mistake I made was turning up the volume of my voice and my insistence.

A more helpful response would have involved a calm recognition of her fear.  I could have said, “Oh, Suzy, I know how scary the thought of not paying your bills is to you.”  After I knew she heard me, I could have calmly asked how to fix this clerical error.

Whenever you say, “I get how you’re feeling,”  you move the emotional thermostat to calm.

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