Is it Better to Hold in or Express Emotions?

“You cannot make yourself feel something you do not feel, but you can make yourself do right in spite of your feelings.”

Pearl S. Buck

Have you ever experienced leaders who seem to lose it during meetings or tense interactions with others–emotions spewing out of them like hot lava leaving an active Mount St. Helens?  Or, dealing with those analytical, controlled and “closed” leaders who are always appear to be emotionally constipated?

Feelings expressed or feelings repressed……

Which one do think is most damaging to your health?

Those Who Feel and Express….

Two types of studies tend to illustrate how expression of some emotions in leaders might have serious long term consequences for health.

First, Ed Suarez, Ph.D. at Duke University illustrated an association between anger, hostility and a very important inflammatory marker of cardiovascular disease called C-reactive protein (others have found the same outcome with homocysteine).  In his study of 123 healthy non-smoking men and women he found that anger and hostility were significantly associated with higher levels of C-reactive protein while controlling for other factors ((Suarez, E. (2004). C-Reactive Protein Is Associated With Psychological Risk Factors of Cardiovascular Disease in Apparently Healthy Adults. Psychosomatic Medicine, 66:684-691)).

This study adds to the growing recognition that practicing “sign language” when being cut off on the freeway may not exactly be the best way to react to social and interpersonal challenges if you want to live long. Indeed, expressing anger seems to increase the inflammatory stress response which can have some negative long term health consequences.

Second, Johan Denollet, Ph.D. has studied a very interesting personality type he calls “Type D” for many years. “Type D” personality types are identified based on their high scores of negative emotions (e.g., worry and anxiety) and low scores on social inhibition, or being insecure socially and lacking assertiveness.

In just one of his many studies, Denollet followed 319 individuals for five years and tracked cardiovascular events that developed. Individuals high in “Type D” were four times more likely to suffer a second heart attack than “non-D Types” ((Denollet J, Vaes J, Brutsaert DL. Inadequate response to treatment in coronary heart disease: adverse effects of Type D personality and younger age on 5-year prognosis and quality of life. Circulation 2000; 102:630–5)).

So, being chronically anxious, nervous and socially uncomfortable seems to be a set of toxic emotions that can be deadly.  Type D personality appears to be a risk factor at least equivalent in importance to the other “conventional” coronary heart disease predictor factors.

Those Who Try Not to Feel and Hold It In…..

What about those of us who don’t express feelings such as anxiety and anger?  These individuals also appear to be at risk to get sick and equally vulnerable to cardiovascular disease and even cancer ((Schwartz, G. (1990). The psychobiology of repression and health. In J. Singer (Ed.), Repression and dissociation (pp. 405-434). Chicago: University of Chicago Press)).

My friend and true “data shaman” Gary Schwartz, Ph.D. at the University of Arizona School of Medicine was one of the first to explore the relationship between those who work so hard to present themselves (and others) in an overly posive light and health.  These “repressive copers” don’t report being anxious at all–in fact, they report just the opposite. Individuals who utilize repressive coping tend to work hard to create very favorable and positive impressions to others (high impression management) and report little or no worry, anger and anxiety (low negative affect).

In fact, those of us who tend to “repress” emotions appear to be at risk for high blood pressure, heart disease and even breast cancer ((McKenna, C., Zevon, M., Corn, B., & Rounds, J. (1999). Psychosocial factors and the development of breast cancer: A meta-analysis. Health Psychology. Volume 18(5) 520-531)).

Apparently, the energy to repress emotions is physiological taxing to ourselves but seems to give most others in our lives a break!  Some preliminary research using 360 degree feedback also suggests these leaders might actually be prone to “over estimating” their strengths and working endlessly to self-promote themselves to others.  These self-enhancing leaders might not only be high risk to derail because of inaccuracy about their skills, knowledge and abilities but they might also be prone to getting sick.

So, three main conclusions:

1. Expressing negative emotions seems to be pretty strongly associated with negative long term health consequences.
2. It’s not the negativity of the emotions per se that is the problem but how leaders cope with these emotions.
3. It seems more important to feel good, than having a goal of merely feeling good.

Still confused?  Well, then try reading and interpreting the leadership literature…..Be well….
[tags]emotions, positive affect, c-reactive protein, type d personality, negative affect, feelings, repression, repressive coping, kenneth nowack, ken nowack, nowack[/tags]

Ken Nowack

Kenneth Nowack, Ph.D. is a licensed psychologist (PSY13758) and President & Chief Research Officer/Co-Founder of Envisia Learning, is a member of the Consortium for Research on Emotional Intelligence in Organizations. Ken also serves as the Associate Editor of Consulting Psychology Journal: Practice and Research. His recent book Clueless: Coaching People Who Just Don’t Get It is available for free for a limited time by signing up for free blog updates (Learn more at our website)