Chapter 12 - Emotions, Stress and Health

Rejection is a stressful personal event for most people. Most people can relate to the emotional pain of rejection:

Not invited to a party. Romantic breakup. Fired from a job. Excluded from a social organization. Positive events can serve to counteract stressful events. Uplifting events can brighten a stressful day.

Usefulness of Emotions Evolutionary theory:

Things evolve for a reason. What is the utility of emotions? Attention: Emotions turn our attention to important things. Your eyes and attention turn toward images that evoke strong emotions, even if you're trying to pay attention to something else. Priorities: Emotions also adjust our priorities. We tend to respond in adaptive ways to emotion-laden situations. (See the growling dog, step away from the growling dog.)

Guilty Knowledge Test:

This test is a modified version of the polygraph test. It produces more accurate results. Interviewers ask questions that should be threatening to someone who knows the facts. Individuals are asked details about a situation (Was the getaway car red? ...green? ...blue?) Someone who shows arousal only respond to the correct details is presumed to have guilty knowledge. This version of polygraph rarely classifies innocent people as guilty, but it is not perfect.

Hans Selye, endocrinologist:

Triphasic pattern of nonspecific physiological responses to injury: General adaptation syndrome: The body's response to stressful events of any type. A complex neurohormonal model of stress that implicated pituitary and adrenal function in the etiology of many chronic diseases, such as hypertension, peptic ulceration, renal disease, arthritis, asthma, and cancer. Initial alarm phase: Activity in the sympathetic nervous system to prepare the body for vigorous activity. The sympathetic system is not capable of sustained, long-term arousal, so the body enters the second phase (below). Resistance or adaptation: The adrenal glads release cortisol and other hormones that maintain prolonged alertness. The body also saves energy by decreasing unnecessary activity. Exhaustion (and death): Fatigue, inactivity, decreased ability to resist illness. Selye: Stress can be positive or negative. It is any event that changes your life.

Coping by Reappraisal:

Trying to see the positive side of the stressful event. Re-interpreting or reframing events to alter your emotional response to it. Recognizing negative thinking patterns and converting them to neutral ones. Normalizing the stressful event. Re-ordering the event in your list of priorities of importance. Imagining another person's perspective of the stressful event—distancing yourself from it.

Flexibility:

Using one or any combination of the above is the situation requires.

How to improve your level of happiness:

Change your activities. Take a walk, join a club, change your study habits, keep a diary, perform an act of kindness, plan a vacation, give someone a gift.

The multifaceted nature of emotions:

Cognitive: My best friend moved away. Physiological: Increased heart rate, sweaty palms. Feeling: Panic, anxiety. Behavior: Pacing the hallway.

Things that correlate with happiness:

A good marriage, close friendships, romantic attachments, close contacts, a sense of purpose in life, a goal in life other than making money, good health, meaningful conversations, religious engagement, having happy friends. Theme: Socialization leads to happiness.

Anxiety:

A vague sense that something bad might happen. Worry, nervousness, unease, something with an uncertain outcome.

Fear:

An emotional response to immediate danger. A belief there is imminent danger, threat of danger, pain, or threat of pain.

Anger and Related Emotions

Anger occurs when someone interferes with your rights or expectations. Disgust refers to a reaction to something that would make you feel contaminated if it entered your mouth. Contempt is a reaction to a violation of community standards. Negative emotions do not necessary lead to aggression or harm. Across cultures people report frequent anger but they seldom resort to aggression.

Short list criteria:

Basic emotions should emerge early in life without requiring much experience. Basic emotions should be similar across cultures. Each basic emotion should have a distinct physiology. Each basic emotion must have its own facial expression. Unfortunately, there are problems with each of these criteria. All emotions appear gradually, most emotions appear cross culturally so it is not possible to eliminate emotions to identify a few basic ones, and physiological measurements do not distinguish among emotions. There is some research evidence in support of the last criterion.

Measuring stress:

Multimodal assessment. Multi-situational assessment. Multiphasic assessment (what is stressful at one phase of life might be trivial at another phase). Big events / daily hassles. Ratings of importance or valence. Ratings of counteracting forces, uplifting events. Cumulative impact.

Basic Emotions

1/3 of a second eyebrow raising: The 1/2 of a second eye brow raise is seen cross culturally when people greet one another in a friendly manner. This nonverbal expression was identified in the 1973-1974 ethology research of Irenäus Eibl-Eibesfeldt.

Physiological measures:

Any stimulus that arouses emotion alters the activity of the autonomic nervous system (ANS)—the section of the nervous system that controls the organs such as heart and intestines. Advantage: Objective measurement. Disadvantage: How do you determine which emotion you are measuring?

The Schachter-Singer theory:

At around 1962, the Schachter-Singer theory was proposed by Stanley Schachter and Jerome Singer. Their theory is a combination of the James-Lange theory and Cannon-Bard theory where emotions are detected through the physiological changes and also the environment around the person. For example, heart rate increases along with being in danger can be interpreted as fear whereas heart rate increasing along with being with someone you love would be interpreted as excitement. If you assume the posture of sadness, you feel sadness. But how and why do people get into the posture in first place? Ordinarily, a cognitive appraisal of the situation enters into the process. How do you know whether you were angry or frightened? Anger and fear are similar physiologically. Your autonomic changes alone cannot tell you which emotion you are experiencing. The intensity of the physiological state (the degree of sympathetic nervous system arousal) determines the intensity of the emotion, but a cognitive appraisal of the situation identifies the type of emotion. Researchers have tried to measure participants' interpretations of emotions in response to medication and placebos, while also manipulating the type of emotion they were likely to report. Those experiments have produced mixed results but the overall finding (the interaction of sympathetic nervous system arousal and appraisal leads to a report of emotion) has been supportive of the theory.

Anxiety, Arousal & Lie Detection

Better interview questions also help interviewers to detect lies. "What were you doing at the time of the crime," is a question that allows an individual to report rehearsed information. Better strategies: The interviewer asked the individual to describe the event backwards (it is easier to recall the truth than a lie). The interviewer asks detailed but unexpected questions. The interviewer asks for a drawing of what took place.

Basic Emotions

Do humans have a basic set of emotions, within which there are gradations, or do we have a long and complex list of qualitatively different emotions? Early evolutionary researchers hypothesized we have only a few basic emotions because there are only a few facial expressions of emotion and those facial expressions are seen throughout the world. Early psychologists shared that perspective. Examples of basic emotions that make the "short list." Happiness, sadness, anger, fear, disgust, surprise, contempt, shame, guilt, interest, hope, pride, relief, frustration, love, awe, boredom, jealousy, regret, embarrassment, amae (Japanese word for the pleasant feeling of depending on someone else / the feeling of comfort in another person's acceptance), loneliness, heroism, amusement, peace, wonder.

Facial Expressions:

Does each emotion have its own facial expression? Why do we have facial expressions of emotions? Eyes wide open: search for danger in the environment. Eyes squinted: search for something disgusting in the immediate environment Combined eye muscles plus a mouth-muscle smile: Happiness (as contrasted with a forced voluntary smile for a photograph that does not employ eye muscles). The combined eye / mouth muscle smile is known as a Duchenne smile. Research findings: The Duchenne spontaneous smile is associated with happiness in adulthood, competence, long-lasting relationships, and longevity.

Positive Psychology

Does money buy happiness? No, but poverty (and especially poverty plus illness) buys unhappiness. Wealth does not necessarily make people happy, but poverty makes them unhappy. Poverty coupled with illness makes people unhappy. Comparing one's income the the income of someone more wealthy makes people unhappy. People in wealthier nations report more satisfaction than people in poorer nations.

Problem-focused coping:

Doing something to improve the situation.

Basic Emotions

Emotions is detected by context as well as facial expressions. Posture Touch Tone of voice Gestures Direction of eye gaze Tears Personal space When researchers show photographs of people expressing emotions through facial expressions, observers sometimes disagree with one another concerning which emotion is expressed. They sometimes see more than one emotion on each face. Their interpretation of the emotion may differ from what the person in the photograph was experiencing emotionally. Thus, this line of research does not support the hypothesis that there are basic emotions.

Updated definitions of stress:

Event or events that are interpreted as threatening to an individual and which elicit physiological and behavioral responses. Daily hassles theory: Big events can be stressful, but an accumulation of small daily hassles also causes stress.

Hypothesized steps and pathways:

First, sympathetic fibers descend from the brain into both primary (bone marrow and thymus) and secondary (spleen and lymph nodes) lymphoid tissues. These fibers can release a wide variety of substances that influence immune responses by binding to receptors on white blood cells. Though all lymphocytes have adrenergic receptors, differential density and sensitivity of adrenergic receptors on lymphocytes may affect responsiveness to stress among cell subsets. For example, natural killer cells have both high-density and high-affinity β2- adrenergic receptors, B cells have high density but lower affinity, and T cells have the lowest density. They were named natural killers because of the initial notion that they do not require activation to kill problematic cells. They act naturally. Second, the hypothalamic-pituitary-adrenal axis, the sympathetic-adrenal-medullary axis, and the hypothalamic- pituitary-ovarian axis secrete the adrenal hormones epinephrine, norepinephrine, and cortisol; the pituitary hormones prolactin and growth hormone; and the brain peptides melatonin, β-endorphin, and enkephalin. These substances bind to specific receptors on white blood cells and have diverse regulatory effects on their distribution and function. Third, people's efforts to manage the demands of stressful experience sometimes lead them to engage in behaviors—such as alcohol use or changes in sleeping patterns—that also could modify immune system processes. Thus, behavior represents a potentially important pathway linking stress with the immune system.

Positive psychology is the study of features that enrich life:

Happiness, hope, creativity, courage, responsibility. It includes not only momentary happiness, but also subjective well-being. Subjective well-being is a self evaluation of one's life is pleasant, interesting, satisfying and meaningful.

Emotions influence cognitive reasoning:

Happy: Overly optimistic, difficulty discriminating among weak and strong arguments. Sad: Realistic Depressed: Overly pessimistic, distorted sense of personal efficacy and likely outcomes. Emotions may either guide or impair decisions.

Stress

Health Psychology: Research and clinical practice that addresses how people's behavior influences health. Why do people smoke? Why do people fail to fill prescriptions? What can people do to reduce pain? What can people do to cope with illness?

Fear and Anxiety

If danger is paired with a stimulus, we learn the association and respond with a startle response to the stimulus. For example, if a light is paired with a shock, the light eventually produces the startle response independent of the shock.

Intelligence: Gardner

Intrapersonal intelligence entails the capacity to understand oneself, to appreciate one's feelings, fears and motivations. It involves having an effective working model of ourselves, and the capacity to use such information to regulate our lives. Recall the critique of Howard Gardner's multiple intelligences...they are conceptually interesting but the absence of g lacks a solid research base.

Understanding facial expressions:

Is there cross cultural similarity in all facial expressions? There are similarities in many facial expressions. But researchers have found a few cross-cultural differences in the capacity of individuals to report emotional expressions. There are regional accents, or small variations, in facial expressions in different cultures. We are better able to decode facial expressions from our own culture and subculture than that of other cultures and subcultures.

Emotional Intelligence

Measures of emotional intelligence predict friendships, happiness, and life satisfaction. They do not add appreciably to the variance accounted for by measures of factors associated with intelligence and personality. For example, if personality and intelligence factors explain 65% of the variance in a study of the link between those factors and some sort of outcome, the addition of an emotional intelligence measure or cluster of measures might raise that figure to only about 67% of the variance. This is not a real research example. It is an made-up example to illustrate what might happen statistically when a new variable fails to contribute appreciatively to predictive validity.

Stress

Measuring stress is difficult because people interpret items on scales differently and people experience and interpret stressful events differently. An event may have different meaning depending on how people interpret an event and whenever they perceive any control over the event. Stressful events are not equivalent in valence across people.

Positive Psychology

Older people tend to be happy than younger people. They have accomplished (or failed to accomplish) their goals. They stop worrying about their goals. They have more personal agency in choosing their activities. They attend happy events, they turn down non-preferred activities. They stop trying to impress other people and they do what pleases themselves. There are age cohort variations and cross cultural variations in what makes older people happy.

Stress and Health

Other models hypothesize a reorganization of the immune system, a shift in the balance of the immune response, and simultaneous enhancement and suppression of the immune response by altering patterns of cytokine secretion. In other words, at a cellular level the body gets confused as it responds to chronic stress. It exerts natural immune responses, it exerts alarm responses, and it suppresses protective responses. The resulting confusion contributes to the development or worsening of disease. Even large stress-induced immune changes can have small clinical consequences because of the redundancy of the immune system's components or because they do not persist for a sufficient duration to enhance disease susceptibility. In short, the immune system is remarkably flexible and capable of substantial change without compromising an otherwise healthy host. However, the flexibility of the immune system can be compromised by age and disease. It is possible chronic stress reduces the immune system's self-regulation. Immune reactions sometimes are exaggerated and pathological, as in asthma, and suggest loss of self- regulation. Disease processes can change in the immune system from flexible and balanced to inflexible and unbalanced. Is it possible chronic stress does the same thing?

Circumplex theory:

People have difficulty describing their own emotions. This difficulty suggests that individuals do not experience, or recognize, emotions as isolated, discrete entities, but that they rather recognize emotions as ambiguous and overlapping experiences. Similar to the spectrum of color, emotions seem to lack the discrete borders that would clearly differentiate one emotion from another. Emotions are highly intercorrelated both within and between the subjects reporting them. People rarely describe feeling a specific positive emotion without also claiming to feel other positive emotions. These intercorrelations among emotions, often obscured in experimental paradigms of basic emotions, are addressed head-on by dimensional models of affect. Dimensional models regard affective experiences as a continuum of highly interrelated and often ambiguous states. Extensive and detailed study of the intercorrelations among emotional experiences, using statistical techniques such as multidimensional scaling and factor analysis of subjective reports of emotional words, faces, and experiences, has repeatedly yielded two-dimensional (2-D) models of affective experience. These dimensions have been conceptualized in different ways: positive and negative affect, tension and energy, approach and withdrawal, or valence and arousal. Despite the differing descriptive labels applied to these dimensions, the 2-D structure is found consistently across a large number of studies.

Emotions and brain damage:

Phineas Gage: Little emotion, poor and thoughtless decisions. "Elliot," 1994, prefrontal cortex surgery to remove a tumor: Almost no emotional expression, no impatience, no frustration, no joy for music art, almost no anger. Difficulty making reasonable plans. He could anticipate probable outcomes but he could not render a choice. He lost the capacity to keep a job, invest money intelligently, and maintain normal friendships.

Emotion-focused coping:

Regulating one's emotional reaction.

Reappraisal:

Reinterpreting the situation to make it seem less threatening.

Research on Emotion

Research on emotion is fascinating but difficult. The components of emotion, or the cognitive and feeling aspects, are the hardest to measure. Behavioral and physiological measures are more objective, but they have their own problems. The best solution is to approach any question of emotion with multiple measurements. If multiple measurements and multiple approaches to research result in the same conclusions, researchers gain confidence in the overall hypotheses and findings.

Fear and Anxiety

Research; operational definition of anxiety: An increase in the startle reflex. Startle reflex: A quick and automatic response that follows a sudden stimulus such as a loud noise. The startle reflex is enhanced when we perceive danger. The startle reflex is enhanced for people who are prone to frequent anxiety. Both anger and happiness diminish the startle reflect. Learned associations can modify the startle reflex.

Behavioral Observations:

Researchers infer emotion from people's behavior and its context. They especially watch facial expressions. Advantage: Rating scales help to structure observations and make them more reliable and valid. Disadvantage: The process is interpretive and interpretations can be incorrect at times. Also, a person can smile through pain or cry from happiness. The rating criteria would need to capture these affective incongruences. Observations work best if they are unobtrusive.

Positive Psychology

Satisfaction in cross-cultural surveys also is positively correlated with: Individual freedom, social equality, education, good opportunities for women (and men?), governments for corruption, diversity. Individual temperament predicts happiness. Twins have a high level of happiness correlation. If one twin is happy it is likely the other twin is happy. Level of happiness can fluctuate, but the baseline is about the same across time for most people. Children are a source of joy, but the stress of parenting in any given moment might not be a source of joy. Happiness appears to be more internal and external. A sunny day can make someone happy, but temperamentally happy people are more likely to rate themselves happy on a sunny day. Unhappiness is predicted by events: divorce, death of spouse, loss of job.

Emotion-focused coping:

Suppressing emotions. Seeking social support. Engaging in relaxation. Exercising. Finding a form of distraction. Practicing self-redirection.

Measurement:

Self report: Asking people about their emotions. Asking people to rate the quality and strength of their emotions. Advantage: It is quick and it is fairly easy to gain research participation. Comparisons across people are difficult because people interpret scales differently. Rate your level of happiness from 1-10. Does a 6 for one person mean the same thing as a 6 for another person? Even with anchors (explanations) of each number, ratings remain subjective.

Coping with Stress

Some people have catastrophic reactions to small events. Some people have small reactions to catastrophic events. Examples of maladaptive coping: Anger and aggression. Hostility. Complaining. Giving up. Social isolation and avoidance. Substance use and abuse. Gambling. Over-eating. Cognitive errors (catastrophizing, blaming, magnifying the negative, overgeneralizing, etc.). Self harm. Silly behavior. Reactions to stress are determined by a variety of influences: Expectancies. Interpretations. Personality variables. The stressful event, itself. The presence of daily hassles / cumulative stress. The capacity to appraise and then re-appraise events. Available coping options.

Resilience:

Some people learn and build their resilience by practicing adaptive coping techniques. Some people seem to handle stress better naturally. Some people learn resilience by observing role models. Resilience is the ability to handle difficult situations with a minimum of distress.

Stress and Health

Stress may increase the risk for diabetes mellitus, especially in overweight individuals, since psychological stress alters insulin needs. Chronic stress and time pressure may also lead to plaque buildup in the arteries (atherosclerosis), especially if combined with a high-fat diet and sedentary living. There is no scientific evidence of a direct cause-and-effect relationship between the immune system changes and the development of cancer. However, researchers are interested in whether they may be links between stress, tumor development, tumor suppression, and metastasis suppression.

Measuring Emotions

The ANS consists of the sympathetic and parasympathetic nervous systems. Sympathetic nervous system: Chains of neuron clusters just to the left and right of the spinal cord. The sympathetic nervous system arouses the body for vigorous action. It is part of the "fight or flight" system because it increases heart rate, breathing rate, sweating, and flow of epinephrine (adrenalin). Parasympathetic nervous system: Neurons whose axons extend from the medulla and the lower part of the spinal cord to neuron clusters near the organs. The parasympathetic nervous system decreases heart rate, and it promotes digestion and other nonemergency functions. It is the "rest and digest" system. Both systems are constantly active but one system can temporarily dominate activity. Danger activates the sympathetic nervous system. Attention to faraway possible danger activates the parasympathetic nervous system. Most situations activate both systems. To measure emotion, researchers measure sympathetic nervous system arousal: Heart rate, Breathing rate, Momentary changes in the electrical conductivity across the skin, Cortisol level in saliva. Physiological measurements do not tell us which emotion someone is feeling.

The Cannon-Bard theory:

The Cannon-Bard theory: Walter Cannon and Philip Bard. Cannon argued that physiological responses could be interpreted as more than one emotions. For example, increased heart rate could mean anger or excitement. There is an interpretive process that mind uses to detect emotions. From the experiments they conducted, they concluded that emotions do not depend solely on the responses of the body. Emotions are interpretive and they happen independently.

Emotional intelligence:

The ability to perceive, imagine, and understand emotions and to use that information in making decisions. The idea of emotional intelligence is popular, but research evidence concerning the construct of emotional intelligence is weak. Definitional problems. Measurement problems. Problem of overlap with other cognitive constructs. Poor predictive validity.

Stress and Health

The foregoing studies notwithstanding, the pathways between stress and the immune system are not well understood. We need more information about the effects of stress on natural and specific immunity. Studies, even when significant, do not produce robust effects. It is possible that factors other than (or in addition to) stress are at play.

Maier and Watkins (1998) proposed an even closer relationship between stress and immune function:

The immunological changes associated with stress were adapted from the immunological changes in response to infection. Immunological activation in mammals results in a syndrome called sickness behavior, which consists of behavioral changes such as reduction in activity, social interaction, and sexual activity, as well as increased responsiveness to pain, anorexia, and depressed mood. This syndrome is probably adaptive in that it results in energy conservation at a time when such energy is best directed toward fighting infection. There are parallels between the behavioral, neuroendocrine, and thermoregulatory responses to sickness and stress. The common thread between the two is the energy mobilization and redirection that is necessary to fight attackers both within and without.

Fear and Anxiety

The increase in the startle reflex depends upon the activity of the amygdala. People vary in the responsiveness of their amygdala, and therefore their tendency toward anxiety. That tendency remains fairly consistent for an individual over the course of time, based partly on genetics, partly on epigenetics, and partly on top-down connections from the area of the frontal cortex that suppresses the amygdala. People who have highly responsive amygdalas are more likely than others to report many emotionally unpleasant experiences: Soldiers with strong amygdala responses at the start of service are more likely than others to report severe stress in response to combat. People with amygdala damage no longer respond quickly to complex emotional signals in the way that others do.

Emotions and the Brain

The limbic system is the major primordial brain network implicated in emotions. It is a network of regions that work together to process and make sense of the world. Neurotransmitters, such as serotonin and dopamine, are used as chemical messengers to send signals across the network. Brain regions receive these signals, which aid us in recognizing objects and situations, assigning them an emotional value to guide behavior and making split-second risk/reward assessments.

Emotions and the Brain

The limbic system sits under the cerebrum (the largest and newest part of the brain) and is made up of structures such as the hypothalamus, hippocampus and the amygdala. The amygdala attaches emotional significance to events and memories. The hippocampus reminds us which courses of action are congruent with our mood. If you feel good, you might take a walk outdoors and enjoy the sunshine. If you feel bad, you might commiserate with a friend. Some people with depression have hippocampal volume loss. Amygdala: The amygdala is an important brain region involved in attentional and emotional processes. This is where attention gets directed. Social processing, specifically the evaluation of faces in social processing, is an area of cognition specific to the amygdala.

Stress:

The nonspecific response of the body to any demand made upon it.

Anxiety, Arousal & Lie Detection

The polygraph records sympathetic arousal: blood pressure, heart rate, breathing rate, electrical conductance of the skin. The assumption is that people feel nervous when they lie and therefore increase their sympathetic nervous system arousal. The polygraph unfortunately has a high false positive rate, as high as 37% in the textbook example False positive: People who are not lying are judged to be lying.

Stress and Health

The relationship between stress and illness is complex. The susceptibility to stress varies from person to person. Among the factors that influenced the susceptibility to stress are genetic vulnerability, coping style, type of personality and social support. Not all stress has negative effect. Studies have shown that short-term stress boosts the immune system, but chronic stress has a significant effect on the immune system that may ultimately manifest as illness. Chronic stress raises catecholamine and suppressor T cells levels, which suppress the immune system. This suppression, in turn raises the risk of viral infection. Stress also leads to the release of histamine, which can trigger severe broncho- constriction in asthmatics.

Emotional Intelligence

What are the skills that are reflected by emotional intelligence? Accurately reading facial expressions? Interpreting tone of voice? Understanding congruity and lack of congruity between a person's feelings and their facial or postural expression of a feeling? Interpreting postures? Capacity for empathy? Anything depicted here? Researchers have not decided whether emotional intelligence is a trait or a set of abilities. Other measurements problems re: emotional intelligence: Can you separate emotions from conceptions of morality? Are you measuring conformity rather than emotional ability? Are you measuring knowledge rather than emotional ability? Once researchers remove the variance accounted for by these other variables, the remaining results (the variance accounted for only by emotional intelligence) are weak. Summary: There is no shortage of advice and hypotheses concerning emotional intelligence. Common sense seems to tell us there might be something that constitutes emotional intelligence. There is no shortage of specialists trying to teach people to exercise emotional intelligence. People can describe emotional intelligence and its hypothesized components, but researchers have not found a good way to measure it or to demonstrate its validity and reliability.

Emotion, Arousal and Action

William James, Carl Lang: James-Lange Theory of Emotion Your interpretation of a stimulus evokes autonomic changes and sometimes muscle actions. Your perception of those changes is the feeling aspect of your emotion. Your appraisal of the situation is the cognitive aspect of the emotion. William James, Carl Lang: James-Lange Theory of Emotion 1. Situation 2. Appraisal (What's that? What's happening?) 3. Action (physiological and behavioral) 4. Perception of the actions (feeling). Decreases in body reaction decrease emotional feelings. Increases in body reaction increase emotional feelings. For example, research shows if you assume a posture consistent with sadness, you begin to feel the emotion of sadness. The James-Lange theory originated from two theories William James (1884) and Carl Lange (1887). They came up with the idea separately but around the same time. Their theory suggest that emotions are caused by the physiological changes in our body when there is an external stimuli. It is when we detect these physiological changes, that we experience the emotion. For example, we feel fear because an external event causes our heart rate to increase.

Problem-focused coping:

Writing about emotions (but not while emotions are raw) to gain perspective. Asking questions so that you know what to expect. Figuring out ways to exert control over the situation. Practicing responses in less stressful but similar situations (stress inoculation training). Other forms of behavioral rehearsal.