As physicians, we are regarded as intelligent. Are we, as a community, as emotionally intelligent as we could be? The answer is no. Let’s face it. We are trained from the time we are medical students to disconnect and suppress our emotion, and we are taught to appear stoic and strong. Showing emotion in front of patients is discouraged, even in a situation that would be deemed acceptable by most. Consequently, we walk around stuffing whatever comes up naturally, and over time this can result in occasional (or for some frequent) emotional outbursts (usually categorized as angry and disruptive). The hard truth — we have been trained to the exact contrary of being emotionally intelligent. We are trained to be emotionally suppressed.

Defining emotional intelligence

Emotional intelligence is defined by Andrew Coleman’s Dictionary of Psychology as:

“The capability of individuals to recognize their own, and other people’s emotions, to discern between different feelings and label them appropriately, to use emotional information to guide thinking and behavior, and to manage and/or adjust emotions to adapt environments or achieve one’s goal(s).”

There is growing research that links high emotional intelligence to lowered physician burnout, and more effective physician leadership.

Emotional intelligence is said to be comprised of four major components: emotional awareness, emotional honesty, emotional literacy and emotional management.

Emotional awareness is the recognition. Emotional honesty is acknowledging and accepting the emotion that is present without judgment. Emotional literacy is the ability to communicate your feelings clearly. And emotional management can be broken down into two parts: The first is managing our emotional behavior. That is, not allowing our emotions to completely determine our actions. The second part of emotional management is the ability to recognize, manage and redirect the emotions of others. That is not to cause them to suppress emotion, but to facilitate and empower healthy expression.

Emotional awareness and emotional honesty

It seems obvious that when an emotion shows up, you’d know it was there. But it is not always that easy. Growing up as a child witness of domestic violence, I learned to fear the emotion of anger, and cover up sadness. For many years I could only access positive emotion, and when negative emotion showed up, I simply distracted myself so as not to feel it. It was only in the last 10 years that I came to distinguish anger and sadness for what it was and learned that what I needed to do with it was to feel it.

There are times that an emotion can have been held in for so long, that the person feeling it can no longer identify it clearly. A friend of mine, who is a therapist, would ask me how I feel, and I would always respond with “I think.” One day she pulled out a piece of paper, and on it was a feelings chart. We both had a laugh, but her point was well received, and I kept that chart. The feelings chart, while seemingly juvenile, is a great way to increase your facility of identifying the exact feeling. The more aware you become, the less power the feeling itself has over you. As doctors, we deal daily illness, death and dying. Added to this is the stress of the work environment and whatever stressors our personal lives bring. Emotions are inevitable. Learning to identify and accept them without judgment creates the opportunity for our own healing.

Emotional literacy: Communicating honestly about your feelings

The mere idea of communicating feelings has always occurred to me as weak and unnecessary. However, I have come to know personally, as well as through the many patients I’ve seen, that NOT communicating the emotion does the most harm.

Whether we like it or not, our feelings are constantly being expressed in our behavior both verbally and nonverbally. While we may try to suppress the verbal expression, the tone of voice (i.e. sharp or sarcastic versus warm and empathetic) can be as revealing as the words themselves. Similarly, body language and facial expression reveal the true nature of our emotions, even when verbal expression says differently. The point is that with our patients, with our staff and with our families, we are communicating. Emotional literacy requires that we become aware of what we are feeling and communicate that with intention, respect and as much compassion as possible.

As physicians, expressing feelings can be new — and quite frankly frightening — as it requires us to be vulnerable in environments that traditionally don’t feel safe. In the end, however, we cause more suffering by trying to suppress, than working towards healthy expression. Here are a couple of tips on expressing feelings:

• Thank the person with whom you are speaking for listening. Acknowledge the difficulty that may be present in the expression.
• Express yourself in a relatively quick manner. Don’t talk on and on — just tell them what you are feeling and why.
• Listen before defending. Your expression will create an opening for theirs. Be the safe space you want them to be for you.

Emotional management: The emotion does not dictate the behavior

When you can identify, accept and communicate what you are feeling effectively, it allows for more effective behavioral management of emotions. When we understand that we are not our emotions, it gives us more power in our expression and management. Self-redirection becomes easier and creates healthier and more peaceful state of mind over time. Furthermore, when you become facilitated with managing your emotional responses, you will learn to dance with the emotions of others. When we realize that people are not responding necessarily to us, it allows us to disconnect from the seemingly personal nature of others’ emotional states, and be more compassionate in our response.

There is a growing interest in the research community about the benefits of increasing emotional intelligence in physicians. Benefits span from increased doctor-patient communication due to increased physician empathy to decreased physician burnout, enhanced physician leadership and overall improved office culture. While the initial studies look promising, there is still more research to be done to determine the implications of increasing emotional intelligence physician practice behavior, well-being, leadership and culture.

Maiysha Clairborne is an integrative medicine physician and can be reached at The Stress Free Mom MD.  She is the author of The Wellness Blueprint: The Complete Mind/Body Approach to Reclaiming Your Health & Wellness. 

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