Features Health and wellness
The Emotional

Nothing clears a room of firefighter spirit and vitality like when you say that the training at hand will be on emotions. This is one of the reasons that I love to directly address it in trainings and presentations. As an often overlooked and underappreciated component to a mental wellness program, training, and sometimes even therapy, emotional understanding and management play a key role in recovery and resilience.  

You may think that you have no control over how you feel. And, in some cases, this is true enough. There are two things about this that we need to unpack. Firstly, are you sure what you feel isn’t actually a thought? Since emotions versus thoughts is a common confusion in therapy, it is likely that you get confused on this point as well. There are many things that we say we feel — I feel stupid, I feel like a failure, I feel like that went well, I feel that I need to try hard, I feel that my crew doesn’t like my haircut, etc. Each and everyone one of these statements is a thought. 

As part of the three-factor understanding of a human experience (thoughts, feelings, behaviours), we need to be accurately identifying each. Thought statements often take on a feeling vibe when we are confused about how we actually feel (or lack the language to describe it), so we reach out to cognitions to try to get the point across to ourselves or others. For instance, when you think about grief, what do you feel? Did the terms heavy, empty, heart is sinking, or low, come to mind? These are common responses I get, yet each is a metaphor. Metaphor is a realm of thinking, and is useful when we don’t have the verbal chops to get our experience across. But, this also makes treatment hard at times. Commonly, I hear “I feel overwhelmed because…”. After listening, I often explain that, while I can sympathize, I just don’t have any skill or tool that I know of that will help them feel “underwhelmed”. Humour, the great pry bar, allows us to further explore this while removing some of the edge of the heaviness at hand. Overwhelmed is the experience of feeling multiple things strongly and being confused about which is most dominant. Therein lies exactly the key to feeling back in control — identify which emotion is the most dominant and exercise your tools on treating that particular emotional disruption. This is the primary emotion.  

Now, the philosophy of Stoicism got a lot of flack for the misconception that it is an emotionless way of life. Of course, this is an imperative function of successful therapy. Seneca, a Stoic philosopher, discussed not ignoring or fighting an emotional response: “Let not the eyes be dry when we have lost a friend, nor let them overflow. We may weep, but we must not wail.” This notion finds a comfortable home in modern psychotherapy. Using cognitive behavioural therapy, I help individuals identify “primary” and “secondary” emotional responses. The primary responses are automatic and uncontrollable to a point.

These are the emotions the Stoics would also have suggested are part of nature; normal and common human experiences. The secondary emotional responses, however, are up to us. The Roman emperor Marcus Aurelius understood this well: “It’s not what men do that disturb us… but, your opinions (judgements) of what they do. Take away those opinions — dismiss your judgement that this is something terrible — and your anger goes away with it.” 

As an exercise in emotional management, the Stoics often encouraged looking at difficult situations from the emotional standpoint of having completed this hard task in front of them 1000 times. We could also argue an effective approach may be to look at a situation as if it was weeks, months, or years in the past. If you get into a heated argument with a colleague or friend, for instance, what do you expect to feel in a week, month, or year after that argument? In all likelihood, the problem would likely be resolved regardless of the outcome and you would have mostly, if not completely, moved on. If this is a statement that you can agree with, you can almost hear the Stoic response: “Then, why wait? Practice feeling that way now.”

What tends to happen to us during any difficult situation is that we add to the situation unknowingly and to our detriment. In Part 1 of this cognitive lifestyle series I discussed how we can behave in ways, in response to an event, that actually make things worse for us in the long-term. We can focus on the wrong parts of an event and that will make us feel worse too. 

Identifying what is primary is crucial. Treating the secondary emotion is a moving target that never allows us to get much deeper in the work. 

On purpose, we’ll leave the last bit of work on the emotional topic in the realm of thoughts. Remember, often the strong emotionality that we feel can be understood as us adding to our pain through the focus on secondary emotional reactions, which simply means we judge ourselves. For instance, if I’m struggling post-call I may feel “worried” or “anxious.” Then, as we are apt to do, we may judge that reaction with thoughts such as “this clearly means you can’t take this job, or what is wrong with me?” This thought has follow up emotional reactions like worthlessness, hopelessness, sadness, guilt, shame or any number of other difficult emotions. Equally as possible may be our tendency to rely on anger (at ourselves, others, or the world) which works to actually buffer against the true, primary emotion. Anger is seldom helpful and is frequently harmful. If we are feeling anger, this is your clue to check in to see if there is anything else bubbling underneath that may explain more accurately the strong emotion you are feeling. 

When we are able to remove that judgement, we remove artificially increasing your suffering. This is what CBT calls “sitting with discomfort” and it does, to validate those that may bristle at this, run contrary to our human experience. We have to learn, though, that being uncomfortable, distressed, worried or fearful is not immediately harmful. Those emotions are natural human experiences. They are alarm bells evolved to warn us of real, physical danger. Often, though, when we experience this now it is of social or perceived threats. Our brains can’t tell the difference (Robichard and Dugas, 2015). 

Emotional management comes down to a few hard, but fundamental, understandings.

1.  We need to identify whether this is a real or artificial emotion. This is no easy task at times, but checking in to see whether a judgement is at the heart of the emotion or whether it occurred automatically and naturally, can be a helpful start to understanding. 
2. Removing judgements, regardless of where they land, mitigates the amplification of strong negative emotions. We need to understand that while judgements may come “naturally” to us, they are functioning to undermine the emotional experience at hand. Both the student of Stoicism and the modern psychotherapist would teach limiting our judgements as swiftly as possible
3. Sitting with being uncomfortable. If what you are experiencing is a strong, negative emotional experience and the situation you are in is objectively safe, you are better to sit with it until it naturally dissipates. Formally, this is considered exposure work. We need to understand that the point of this is to instill new learning about ourselves, how we cope, and the messages that we get. Properly understanding this will bolster our confidence (even when these exercises don’t necessarily make me feel better in the moment), desensitize us (making us incrementally more resilient to the next stressor), and decrease the intensity and severity of the experience over time.

Combining these ancient exercises with modern psychotherapeutic understanding and research allows us to take more control over the emotional experiences we have and simultaneously takes away the fear and worry about strong emotional experiences in the future.  

Nick Halmasy is a registered psychotherapist who spent a decade in the fire service. He is the founder of After the Call, an organization that provides first responders with mental health information. Contact him at nhalmasy@afterthecall.org.