Crying is an everyday occurrence in my psychiatry office. Crying can be a sign of sadness, sure, but tears can also be due to anxiety, anger, or any other tough feeling we have in spades. But, without a doubt, as soon as tears emerge, the first thing that happens is my patients, particularly the ones who identify as female, apologize for it — and then they try to make the tears stop.

"Crying is basically a handshake in my office," I reply, in an attempt to try to break up the tension. It is also my way of emphasizing that tears are not just OK and allowed, they are common.

I would love to say my joke typically clears the air and suddenly my patients are able to freely emote in my office, but it is so much more complicated than that. One sarcastic quip isn't going to change behavior that has existed for years. Behavior that is compounded by gender and stereotypes of what it means to show emotion. Behavior that we have shaped over time by telling ourselves not to be angry, to stop crying, or just to smile through it. Eventually, we don't even have to tell ourselves anything because the cues become automatic — like an on/off switch for feelings, that mostly just stays off. For many of us, pausing and allowing ourselves to feel has the sense that it could break us. It is easier (or safer?) just not to feel anything at all.

Express, Don't Suppress

I know that just as well as anyone else, as understanding my relationship with emotions had been the focus of my own therapy for a lot of the pandemic. I spent far too many hours pacing my room, holding stress putty, wondering why my anger "just won't go away," or crying watching a television show, wondering if the tears are actually not about the show, but instead about the hours of patients I had before.

My struggle might be surprising since my job is basically to understand other people's emotions and help them express theirs, but no one said psychiatrists were always good at practicing what we preach. People only see us at work, trying not to take up too much emotional real estate, asking our patients, "How does that make you feel?" It is easy to forget we also have our own emotional lives, because, trust me, we forget we do, too.

Unfortunately for all of us, ignoring our feelings or trying to control them doesn't mean they don't exist. They often do come back sometime later, at their convenience, and usually even stronger than before. 

Despite being someone who literally preaches "feel your feelings," like so many of my patients, I try to suppress my emotions in the moment, believing that "emotions get in the way" and it is easier not to express them. We learn to ignore our body cues (or even exert control over them) and suck it up so that we can go to work, or take care of the kids, or go to school, or any of the hundred other things on our plates. We might even naively think we will have time or energy to process our emotions later, but often, we are still too busy for our feelings then. Unfortunately for all of us, ignoring our feelings or trying to control them doesn't mean they don't exist. They often do come back sometime later, at their convenience, and usually even stronger than before.

The Gendered Nature of Emotions

Still, we try to hold it all in, in part, because we are trying to prove society wrong. One only has to look at the origins of the word hysterical (derived from the Greek hystera, meaning uterus), which we now use to mean extreme emotion, to understand the gendered nature of emotions. We do not want to be "emotional women'' who are somehow not good at our jobs because we — shocker — have feelings. But, on the other hand, we also should not be expected to be stoic to match men in the workplace (as if it is great that men have no emotions as an ideal either), or be shuttled to a mental health professional to have our normal mood fluctuations questioned or, worse (because I've seen it!) medicated away like they are all pathologic.

No matter what anyone says, we are supposed to have feelings, and the full range of them. Showing sadness is not automatically a sign that we have depression and certainly is not a warning of instability. Anger is also valid, too. Just like many other people, there is a limit to my ability to handle anti-science and anti-vax comments as this pandemic drags on. I can keep it together with a patient who expresses those viewpoints and try to educate, but catch me on the street or in text messages with the same comments and you might be exposed to all of the rage that I have been holding in. That doesn't make me a "bad doctor", it is just reality. Sure, sometimes there is a time and a place for certain emotions, but we need to allow ourselves space to feel. To ask ourselves what we can learn from those feelings about ourselves. After all, feelings make us human.

Expressing Emotions Helps You Connect

They also help us connect more with each other and form deeper relationships. Social support helps prevent burnout and reduces stress and loneliness. We may think we are protecting ourselves by not "appearing weak" to others and hiding our feelings, but in stifling our own emotions, we are actually acting mostly out of fear and shame. In truth, by being open and vulnerable, we draw people in. It isn't necessary to tell everyone your entire life story, or do as I did and disclose your mental health history, but it can help to show some degree of struggle or imperfection. To me, this looks like talking about failures and frustrations out loud.

When something is hard, I say it was hard, or if I am struggling with a particular task in my life, like not responding to my e-mail over vacation, I say it out loud. I also have taken to genuinely answering the question "How are you?" even when my patients are the ones asking. Modeling that humanity is also good leadership because it requires courage and empathy, which are not always seen but are valued in the workplace.

Don't Hide Your Emotions From Your Kids

Expressing our feelings makes us better parents, too. For example, if we are feeling particularly angry about something at work, kids can sense our reactions and they want to hear the truth. If they hear from their parents how they honestly feel, it may help them feel comfortable talking openly about their feelings in the future, setting off a majorly positive chain reaction.

It is OK to feel angry, anxious, and sad — our goal is not, and cannot be, to be happy all the time. And even if that were a goal, attempting to stifle all other feelings down to nothing wouldn't get you there. 

We have to start, though, by removing the judgement from the uncomfortable feelings and understanding that there are no "good" or "bad" emotions. We need to name and validate all of them equally, acknowledging that each has a purpose, like the plot of the movie Inside Out, even if they don't always make us feel good in the moment. It is OK to feel angry, anxious, and sad — our goal is not, and cannot be, to be happy all the time. And even if that were a goal, attempting to stifle all other feelings down to nothing wouldn't get you there.

It may feel weird to say that when there are literally songs and t-shirt slogans that tell you to be happy. But, not only has research shown that people with the goal of being happy are actually less happy, but 24/7 happiness is simply unrealistic. Shifting our goal from happiness helps us understand that there is nothing wrong with us if we aren't happy, even if that is what society tells us by pushing us to chase perpetual happiness. We also can recognize there is value in all of our emotions.

So what should we be doing instead of trying to control our emotions?

Name Your Emotions

When we notice ourselves feeling feelings, we should stop and name the emotion we are experiencing. Simply saying "I am feeling anxious" or "I am feeling embarrassed" can even help you feel better. It seems like it is too simple to work, but it actually is validating to put a name to what we feel in our bodies. You should ask yourself, "Why am I feeling what I am feeling?" and "What does having the emotion tell me about myself?" Sometimes answering these questions can give you good information about your triggers, or at least good information for your therapist.

Then, we should try not to make the feelings go away immediately. We will want to, especially with the uncomfortable ones, but we need to try our hardest not to do it. That also means we need to not go right for the numbing behaviors, like alcohol, or even diving into work and being busy. Of course, we live in the real world, and sometimes we won't have a choice and we can't just sit in our emotions in every situation. But, if we can, we should try to go beyond naming.

Reframe Your Thoughts

In these moments, we may notice some negative, judgemental thoughts coming in and it can help to reframe our thoughts in a different way. One common way is to try talking to ourselves like we would a friend, or like a younger version of ourselves. If we tell ourselves to "Suck it up" or to "Stop being useless and not getting anything done," actually pausing and hearing ourselves say those phrases, we would realize we would never talk to anyone else so harshly. With the extra step, we can be kinder to ourselves and not pile onto an already judgemental and hard world. We can instead try something like, "Today was a hard day, and I am getting less done than I would like, but that is OK." This tiny little change can make a significant difference.

Of course, after sitting with the feeling and processing it, it is OK to figure out how to cope. How one does that is up to them, however it might also be emotion or timing specific. For anger, sometimes I like to exercise and a bath or shower, and for sadness, journaling, but that is just me. It is important that we all find out what works for us. The best coping skills are the ones we will do.

While I cannot promise that I am ready to sit here and cry with no attempt to stop it, or say that my attempts of controlling my emotions are behind me, at the very least, I am going to stop apologizing for it. In fact, I am sorry for all the times that I judged myself for having emotions or kept them hidden away. I am sorry for all of the extra weight I've carried (and continue to carry) for trying not to feel. And, I am sorry for anyone else still fighting hard against the same impulse. But, I am not sorry for having human emotions. It is about time I just feel those instead.