Emotional expressivesness is also practiced by doctors. To be alive and to be human is to be somewhere on the scale of low to high emotional expressiveness. Doctors do not yell at their patients, yet if high EE can encompasses pity and negativity, then how the doctor interrelates with the patient is also a factor in patient outcomes.
How much training do physicians receive in this area? My guess is it’s very low. When Chris was first hospitalized, I was not able to visit him for a couple of weeks and during that period I spoke with his doctor over the phone. She said, and I quote, “Well, he’s not one of our sickest patients…” She made it clear without being very clear that he was indeed very sick. Now, what was I supposed to make of a remark like that? It struck fear into my heart. I had no background in the illness. It sounded like a death sentence to me. It too, was expressed emotion.
When I finally got to meet the crew at the hospital, they were not upbeat at all. They were factual, I would say, in that they were using the terminology that they had learned in medical school, but this does not come across well with laypeople like me and in fact, it seems very clinical and scary. I needed reassurance that Chris was going through a rough period but that he would be expected to emerge from this intact and probably even stronger. I did not want talk of diminished expectations. I needed help being strong. I wasn’t getting that message from the hospital environment.
The whole hospital scenario is of dimished expectations, unfortunately. This is expressed emotion. It is a mood, it is art therapy class, it is drab surroundings, it is doctors telling parents and patients that they have a lifelong illness that can only be managed by meds. When they speak about hope, they don’t seem to have a clear view of a happy outcome. They don’t follow their patients long enough to know that there are many happy futures out there.
Most of the doctors in institutions that we have come into contact with are young and in their thirties. What they know about mental illness they were taught in medical school. What they have been taught in medical school can have a tremendous impact on the experiences of people on the ground. They cut off patient hopes for recovery early on through their own lack of experience and their medical school belief that the brain is damaged. This is expressed emotion that negatively impacts the patient and the family.