Stop Triaging Your Emotions
Previously, I published a post entitled Stop Triaging Your Life. I had worked on it for quite a while until I was pretty happy with how it turned out.
Then I realized that I had missed the first step in triage. Triaging your emotions. And that had to be a whole separate post. After years of being in medicine, triaging my emotions was so automatic that I never even thought about it as a step in the process. It was just life.
We are taught very early that we are supposed to be professional, and specifically to act professionally, by setting aside our own emotions. There is actually a very good reason for this. It’s nearly impossible to solve intellectual challenges, like taking care of patients in crisis, when you’re on the floor weeping or so angry that you can’t see straight. So we are taught we can’t feel now, and learn to set the emotions aside, following the examples of our teachers. But we are never taught when later is and what to do with them during that later time when the crisis has passed. So they just sit there, waiting for their chance to be released, felt, and processed.
I wish I had learned how to safely release those emotions. In one memorably terrible week on trauma as an intern; an old man attempted suicide but only succeeded in making the rest of his life more miserable with his survivable head injury; two teenage best friends played Russian roulette and only one survived; a small child was beaten to death by his stepfather. Each time I compartmentalized, as I’d learned, and I kept focused on my job and not the anguish from family members and the obvious tragedy of the events.
As luck would have it, I had a blind date shortly thereafter. We went to see the movie Hook. There is a scene in Hook where Peter Pan has been lost as a baby and lies crying on cobblestones in the rain. Tinkerbell comes and saves him. In the middle of that theater of strangers, my mind wondered “Why couldn’t someone have saved that child?”. And I started to sob. Loudly. In the theater. Uncontrollably. I had to leave. (There was never a second date.)
I understood at the time that the emotional release had been related to the child, but what I didn’t realize was that it was probably all the children, all the gun violence, all the car accidents, all the terrible medical prognoses that had to be delivered.
And I didn’t realize that this was an opportunity to complete the trauma cycle, not just a breakdown in my usual excellent compartmentalization. And that while it was embarrassing, it was also my body’s attempt to restore health and balance.
In their recent book Burnout: The Secret to Unlocking the Stress Cycle, twin sisters Emily and Amelia Nagoski write about how important it is to complete the stress cycle. If it is not done, the trauma lives in our consciousness and our bodies long after. Completing the stress cycle can be done with exercise, laughter, deep breathing, positive social interaction, experiencing affection, crying, and creative expression.
I don’t think I’ve ever laughed harder than I did on the Trauma Service, and now I understand why. We were all unconsciously completing the stress cycle. We allowed ourselves to deal with the immediate stressor but not the stress. The stress comes out when we’re called at 2 am about somethings stupid or the OR doesn’t have our equipment ready. In those cases, the unrelieved past stress results in more stress for ourselves and the people around us.
Compartmentalization serves a purpose, but like triage, it’s no way to live a life. To live a life you have to remember how and when to feel. You may have to give yourself permission and space to feel after a hard day or week. Find a way to review the emotional aspects of your days. Feel the emotions that were present for you. It may even take some time to identify what emotions are actually present, especially if you’re used to ignoring them. If possible, share your experience with a trusted confidant, a friend, a coach a therapist.
But also remember to deal with the stress by completing the stress cycle and getting that energy out of your body and consciousness.
While it may be appropriate in the doctor/patient relationship setting to set aside your immediate feelings, it is vitally important to come back to them later to process and release them. And even more important to NOT triage your emotions when you’re out of the hospital and not working.
