*The translation of this article in French and Portuguese has been made through machine translation and has not been edited yet. we apologise for any inaccuracies.
Most people go through seasons of emotional turbulence, inner stress, and feeling down throughout their lives. Coping with these challenges alongside heavy workloads and medical responsibilities as a physician can be even harder. Here are seven emotional regulation strategies and stress relief techniques to help you self-regulate and improve your well-being as a physician.
Continue reading to learn about emotion regulation and how to develop and improve the skills necessary for staying balanced, focused, and emotionally stable.
Emotional regulation, or self-regulation, is a valuable and empowering skill that helps individuals respond healthily to stressful situations, manage heightened emotions, and achieve their goals more effectively. Like any skill, emotional regulation needs to be taught and practised; it’s not something we are born with. Growing up in a safe and nurturing environment where healthy self-regulation was consistently practised may have instilled some of these skills and habits. However, as life brings changes and challenges in relationships, careers, and the pursuit of life goals, continuous learning and adaptation of emotional regulation becomes essential.
Some of the benefits of practising emotional regulation strategies and techniques include:
- Being able to regulate reactions based on negative emotions such as frustration, anger, and embarrassment
- Being able to calm down when something upsetting or exciting happens
- Being able to focus on a task
- Being able to control impulses
- Act in accordance with their values
- Stay clear about their intentions
- Remain flexible and adapt to situations
- Persist through difficult times
- Take control of challenging situations
- Put forth their best effort and reach goals
Do you know of, or use any effective emotional regulation techniques as a physician? How do you improve your well-being as a physician? Share your valuable insights in the comment section below.
Why is Emotional Regulation Important, Particularly for Physicians?
An inadequate level of emotional self-regulation can lead to heightened and unstable moods or emotions, a surge of negative emotions, a lack of positive emotions, or an inability to respond to stress and challenges in a productive and healthy way.
In more severe cases, individuals struggling with emotional dysregulation may respond to relatively minor negative events in an emotionally exaggerated manner. They may scream, cry, accuse, or blame those around them, or engage in passive-aggressive behaviours or other actions that can disrupt relationships and escalate conflict. Often, it is only in retrospect they realise their reactions were inappropriate or disproportionate, which then may trigger a cascade of additional negative emotions, such as guilt, embarrassment, and self-blame.
On the other hand, a healthy level of emotional regulation supports psychological health and overall well-being. But why would emotional self-regulation be more important for physicians than any other individual?
The answer is, it’s not. Every human being can benefit from practicing and adopting better emotional regulation skills and habits. Life brings challenges to us all. However, working as a physician can be extremely demanding, emotionally, physically, and mentally, which can exacerbate factors making it more difficult to self-regulate.
According to Medscape Report 2023 over 50% of physicians report feeling burned out and 23% report feeling depressed in the US. Recent research also highlights that many physicians suffer from secondary trauma, also called vicarious trauma. In the context of working as a physician, this refers to changes in physical and emotional functioning after working with patients who have experienced stressful or traumatic events. Read more about “Vicarious Trauma in Healthcare Professionals” here.
Being exposed to emotional and stressful situations and events on a regular basis, coupled with heavy workloads, can make it more difficult to stay calm, emotionally balanced, and maintain positive thought patterns. Below, you’ll learn how stress, burnout, and trauma can impact self-regulation before we dive into the seven emotional regulation strategies and stress relief techniques.
Self-Regulation in the Face of Stress, Burnout, and Trauma
Why is emotional regulation more difficult for some than others? There are several factors that may influence one’s capability to effectively practice emotional regulation, periodically or frequently. Here are some of the main reasons according to research:
Emotional Regulation and Stress
Emotion regulation is the ability to automatically or voluntarily influence our emotions to maintain emotional balance and achieve goals.* High levels of stress have various negative effects on our emotional and cognitive functioning, significantly impacting our ability to self-regulate.
Research shows prolonged stress can cause mental fatigue, or burnout, and disrupt the prefrontal cortex, which is crucial for emotion regulation and decision-making. This can lead to emotional volatility and erode emotional resilience, making it harder to cope with setbacks and manage intense emotions, resulting in increased emotional sensitivity and heightened responses.
Prolonged stress also depletes cognitive resources, negatively affecting willpower, self-discipline, and impulse control. Long-term exposure to stress hormones, such as cortisol, can impair cognitive functions like memory, attention, and problem-solving abilities, making it challenging to think clearly and make rational decisions during stressful situations. This often leads to maladaptive and unproductive behaviours, hindering the ability to effectively reach goals and maintain emotional well-being as a physician.
Chronic stress can affect brain plasticity, preventing the development of new adaptive behaviours, which can create a self-perpetuating cycle of emotional dysregulation that is challenging to break free from without interventions, support, and deliberate effort. Effectively managing stress is vital for maintaining emotional well-being and cognitive functioning.
It is important to note, however, that stress per se should not be viewed as something entirely negative. Healthy levels of stress can be beneficial in numerous ways, as it can increase alertness, memory, boost work performance, deepen social bonds, and much more.
Emotional Regulation and Trauma
Individuals who have experienced trauma, particularly during the first two decades of their lives, can experience deficits in cognitive control and emotion regulation.* Neurobiological changes occur in the brains of trauma survivors, impacting the structures and circuits involved in emotion regulation. These alterations can lead to hyperarousal, hypervigilance, and challenges in managing emotions effectively.
Research also suggests trauma can lead to impaired functioning of multiple brain areas responsible for emotional regulation and the development of coping mechanisms like emotional numbing, dissociation, and avoidance, making it difficult to identify and express emotions.
According to a global study conducted by the World Mental Health Survey Consortium, a significant majority of people have experienced some form of trauma in their lives. The results showed over 70% of the general population reported encountering at least one traumatic event, and 30.5% of them experienced four or more traumatic events.
As trauma has a profound impact on emotion regulation and well-being, it is crucial to consider therapeutic support to help individuals cope with and overcome the effects of traumatic experiences. Explore some emotional regulation therapy options below.
How to Self-Regulate? 7 Emotional Regulation Strategies and Stress Relief Techniques
If you notice yourself drifting into a more intense season of your life, personally or professionally, it can be useful to have a few emotional regulation strategies and stress relief techniques in your back pocket to help you navigate life better. Perhaps you’re already in a state of stress, mental fatigue, and feeling as though it’s getting more and more difficult to maintain emotional balance and a positive outlook. If so, it’s never too late to start practicing these self-regulation strategies that can help relieve stress and respond to emotions and challenging events in a healthy, productive way. Here are 7 emotional regulation strategies and stress relief techniques for you to consider before, during, and after an emotional trigger.
Click to read more about each strategy:
- Utilise your sensory system to shift focus and self-regulate
- Use breathwork to regulate your emotional state
- Observe and track your moods, emotions, and behaviours
- Investigate your thoughts and create new narratives
- Cultivate six essential health habits
- Ask for help and support
- Consider emotional regulation therapy
Self-Regulation Strategies During an Emotional Trigger
One of the most effective practices for emotional regulation during stressful or challenging situations is to create a short time gap between feeling and reacting. This pause allows us to consider how we want to respond, even when our instincts push us to act on emotions. The goal is not to suppress overwhelming feelings, which can lead to feelings of powerlessness, disappointment, and shame. Instead, the aim is to gradually extend the time gap between the emotional trigger and our response through practice. This process allows us to distance ourselves slightly from the emotion, enabling us to calm down, refocus, and reflect, resulting in less automatic and explosive reactions. When feeling emotionally triggered, try shifting your attention from your thoughts to your body and the external environment using these techniques:
Strategy 1: Utilise your sensory system to shift focus and self-regulate
Research shows sensation and emotion are closely interconnected, and some studies suggest sensation can serve as a rapid and relatively effortless emotion regulation tool that can be strategically used to enhance positive emotions and reduce negative ones. Sensations can also influence emotion via indirect pathways, such as diverting attention, promoting cognitive reframing, and activating autobiographical memories.
One way of creating a time gap between feeling and reacting is to take a moment to notice and describe the sensations you experience to yourself. What do you feel in your body? Are you experiencing changes like an increased heart rate, temperature, or muscle tension? Take note of your surroundings. What sounds do you hear at this moment? What do you see around you? Can you identify any scents or tastes?
If there is time and space, consider directly influencing your senses through self-soothing activities such as listening to music, drinking tea, having a hot or cold shower, viewing sunlight, breathing fresh air, lighting an aroma candle, or asking someone for a hug.
Strategy 2: Use breathwork to shift your emotional state
According to Dr Andrew Huberman, a professor of Neurobiology and Ophthalmology at Stanford University, the quickest and most effective breathing technique to calm down on a physiological level is the “double inhale, and long exhale”. This breathing technique can relieve stress after only 1-3 times repetitions and can have a significant effect if done for 2-3 minutes.
When we inhale twice, the collapsed alveoli reinflate with air which increases the surface area of the lungs and removes CO2 from the body much more efficiently, making the body feel more relaxed. When we take long exhales, the receptors in the heart sense the increase in pressure and send signals to the brain to slow down the heart rate, which creates an instant relaxed feeling.
Self-Regulation Strategies to Prevent Unhealthy Emotional Responses
If you’re already emotionally triggered by something or someone, it can be very difficult to self-regulate and change your responses if you don’t have a goal of how you would like to respond instead.
Strategy 3: Observe and track your moods, emotions, and behaviours
Instead of focusing on managing and controlling emotions, it can be beneficial to observe and track your moods, emotional reactions, and behaviours instead. Becoming more self-aware and starting to notice repetitive patterns can bring powerful insights which may help you break unhealthy patterns so you can create new, healthy ones which align with your values and goals. This can be done through:
- Daily journaling
- Voice diary
- Mood tracker apps like Moodfit
Strategy 4: Investigate your thoughts and create new narratives
- Investigate your thoughts: In the absence of information, we often fill in the blanks with details of our own. Assess if your thoughts are true and useful and reshape narratives accordingly.
- Use perspective-thinking: Imagine others’ emotions and motivations to foster a more neutral response and facilitate new narratives.
- Engage in constructive self-talk: Pay attention to your thoughts and try replacing negative self-talk with more empathetic, constructive, and encouraging words, as if you are speaking to a dear friend.
Self-Regulation Strategies to Repair and Recover
After being exposed to high levels of stress, heightened emotions, or when you feel exhausted, it is important to take the time to recover. Here are some important practices and habits to consider:
Strategy 5: Cultivate six essential health habits
- Sleep: Prioritise getting enough restorative sleep, as it plays a crucial role in emotional regulation, cognitive functioning, and overall well-being.
- Nutrition: Maintain a balanced diet rich in nutrients to improve your energy levels and immune system.
- Hydration: Stay well-hydrated, as dehydration can impact mood and cognitive function.
- Sunlight: Spend time outdoors in natural sunlight, especially during mornings and evenings, which can improve mood and support your circadian rhythm.
- Movement: Engage in physical activity or exercise you enjoy, as it releases endorphins and reduces stress.
- Breathwork and meditation: Practice deep breathing and mindfulness exercises to activate the relaxation response and calm your nervous system.
Strategy 6: Ask for help and support
Reaching out to friends, family, or colleagues and sharing your feelings and needs with them is an essential step in emotional regulation. Although this may seem obvious, research has shown that physicians experiencing fatigue and burnout tend to resort to isolation, avoidance, and disengagement as coping mechanisms. However, opening up through clear and constructive communication can lead to better understanding and support, promoting emotional restoration and overall well-being.
Strategy 7: Consider emotional regulation therapy
Consider reaching out to a therapist, counsellor, or mental health professional for guidance and support. Some of the most well-known and effective therapy options for emotional self-regulation are:
- Cognitive-Behavioural Therapy (CBT): Helps identify and modify negative thought patterns and behaviours.
- Mindfulness-Based Stress Reduction (MBSR): Cultivates awareness and acceptance of emotions, reducing emotional reactivity.
- Dialectical Behaviour Therapy (DBT): Focuses on emotional regulation, distress tolerance, and interpersonal effectiveness.
By incorporating these emotional regulation strategies and stress relief techniques, physicians, and individuals alike can improve self-regulation, cope with stress, and maintain overall well-being. How do you improve your well-being as a physician? Share this article with a colleague on LinkedIn and Twitter, and let us know which of these strategies was helpful to you in the comment section below.
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