EMOTION What is an Emotion? An emotion is a feeling state with physical, psychological and expressive or social aspects.

There is no one universally accepted definition of emotion, feeling, affect or mood (Nash 1984). The term affect is applied to the subjective experience of an emotion, which is attached to ideas, together with its outward display. An emotion that is sustained is called a mood or a mood state. An emotion consists of five components (Atkinson et al, 1987); 1. an internal subjective experience, e.g. sadness, happiness, anxiety etc. 2. internal body responses, involving the autonomic nervous system, e.g. rapid heart beat, painting, tremour etc. 3. a cognitive appraisal or interpretation of the experience, i.e pleasant or unpleasant etc. 4. facial expression, e.g. surprise, delight, rage etc. 5. reaction to the source of the emotion. Nash et al, (p.239) say because of autonomic arousal, we all recognise that when we experience our emotions, we are aware of physical changes that result from an altered sympathetic nervous system. Evidence of the result of raised levels of adrenaline and noradrenaline: raised heart rate raised blood pressure increased perspiration (sweating) reduced salivation with dry mouth piloerection (goose pimples) dilated pupils rapid breathing reduced bowel contractions raised blood sugar for energy faster blood clotting altered galvanic skin response

Darwin (1872) proposed that emotions are elements of instinctive behavior which have evolved as adaptive responses for or to aid survival of the individual and the species. Darwin based this view on the findings that the expressions of emotional reactions are similar in animals to those in humans both in infants and in adults.

He also observed that the same expressions occur in blind infants and are also remarkably similar in widely differing cultures through out the out. Robert Plutchik (1984) proposes a Psycho-evolutionary Theory of Emotion and defines it as; An inferred complex sequence of reaction to a stimulus, and includes cognitive evaluations, subjective changes, autonomic and neural arousal, impulses to action, and behaviour designed to have an effect upon the stimulus that initiated the complex sequence. Plutchik proposes that; in the Darwinian context, emotions are, appropriate reactions to emergency situations, in order to ensure long-term survival. Emotions help the individual to gain appropriate control over the environment, so as to ensure access to food, sex and giving and receiving of care. emotions are not directly observable and their presence has to be inferred i.e. the expression may be through non-verbal communication. Plutchik also says, emotions are appropriate reactions to emergency situations. They help the individual to gain appropriate control over the environment. He proposes that certain emotions are primary of basic, while others are secondary or derived. He presents 8 basic emotions with their polarities as; joy versus sadness anger versus fear acceptance versus disgust surprise versus anticipation Plutchik also describes EMPATHY as the communication of an emotional state from one organism to another. In its evolutionary context, empathy is the basis of the mother-infant bond, in which both share the emotionally significant experience. Empathy is a very important emotion for health care providers to develop for clinical work. EMPATHY is putting yourself in another persons shoes. That is trying to understand another persons situation as if it were your own. Patients often express dissatisfaction with state of the art technical expertise of doctors and nurses if it is accompanied with empathy.

SOURCES AND CONSEQUENCES OF EMOTIONS - O Mangwiro Primary emotions 1. 2. 3. 4. fear and anxiety anger sadness happiness Winfield and Peay, (1980)

1. Fear and Anxiety

Antecedents fear results from aversive stimulation (such as pain or injury) or the threat of it . in humans, lack of information about events likely to affect one is aversive fear is readily conditioned anxiety may be evoked thereafter by stimuli originally irrelevant to the fear response e.g. Watson and Rayner (1920) Little Albert or baby taught by Watson and Rayner to fear small furry animals by having a loud noise presented simultaneously. source of fear change with age - in view of changes in cognitive capacity. Infants distress when subjected to sudden changes in stimulation such as loud noises or loss of support and later to separation from attached figures. primary school children fear ghosts and monster with more realistic fears such as of bodily injury and physical danger gaining preponderance as they mature. fears of failure and social disapproval become paramount in early adolescence.

Behavioural results Fear and anxiety unpleasant to feel, motivate avoidance of the threatening situation. The termination of anxiety powerfully reinforces the avoidance response making life very restricted the individual who has been shamed or scorned may develop strong (over-generalized) habits of social withdrawal that no opportunity arises to test reality and discover the irrationality of the fears. muscular tension characteristic of anxiety can give rise to pain particularly in the jaw (if clenched for long periods) and the neck and shoulders.

tension in the frontalis (forehead) muscle, which is difficult to relax deliberately, is the source of non-migrainous headaches

2.

Anger
inability to recognize and cope constituency with ones anger results in social and personal maladjustment. assertiveness training - technique helps people communicate angry feelings clearly and appropriately. The generalization of these skills to the expression of other feelings helps to strengthen relationships, reduce isolation and improve self-esteem.

Antecedents the classical explanation for the arousal of anger is frustration when a desired reinforcer is withdrawn or otherwise made unavailable anger is the result. Frustration - aggression Hypothesis (Dollard et al 1939)

Behavioural results Anger inspires attack, which may consist of blows and shouting, or be restricted to intention movements movements such as glares, clenched first, threatening gestures, a raised voice and bared teeth. anger at oneself may be inferred when self-injurious behaviours occur. in people brought up to be over nice, the experience of anger can result in anxiety lead to denial of anger may be cover expressed through dreams and fantasies e.g. of mutilation and calamity) or to over compensatory defenses such as an unrealistically protective and subservient attitude towards the source of the anger.\ unexpressed anger is a stressor has bad effect on health. assertiveness is the term for communicating about angry feelings which are informative, without being seen as aggressive being able to cope constructively with anger is an invaluable skill which tends to strengthen rather than weaken bonds with others.

3. Sadness
Chronic sadness constitutes the important and pervasive clinical syndrome of depression. characteristics conscious affect of sadness, hopelessness, withdrawal from social situations, undue pessimism (about present that future) behavioural signs insomnia, lack of energy and crying easily

Antecedents usually follow a loss of some sources of gratification loss death of a loved one, loss of anything of psychological ---significance job, possession, hope loss physical wholeness e.g. advancing age, accident, illness. experience of helplessness (Seligman 1975) has been proposed to precipitate depressive episodes learned helplessness associated with loss of control victim give up hope that adaptive responses can be made to a given situation, and they fail to try, even if such responses are objectively available. passivity and hopelessness reflect the persons negative expectations about his ability to control important reinforcers.

Behavioural results * affective (low spirits) cognitive (reduced expectations) behavioural (passivity and lack of positive reinforcers) irritability, weight loss, sexual disinterest and sleeplessness. agitation and also psychomotor retardation. availability of social supports in the form of trusted friends and confidants who allow the stressed individual to express unhappy emotions and remain assured of personal worth, seems to be a major variable in mitigating the illness susceptibility results of ------- trauma (Cassel; 1976, Cobb; 1976) Depression result in suicide shows peaks of incidence in adolescence and after 60.

4. Happiness
pleasant emotion. Antecedents positive reinforcement, whether by presentation of a positive stimulus or removal of an aversive one, is the most usual source of good feelings. Source of pleasurable emotional experiences food, drink, warmth. social reinforcers attachment to trusted intimates, status, social stimulation for others, praise etc. social reinforcers are vital contributors to feelings of self esteem, security and worth. They are relevant to ones estimation of oneself as loveable and capable and thereafter to ones expectations about being able to cope with lifes difficulties.

conditioned reinforcers such as money or familiar objects associated with happiness in the past, seem to be able to act as partial substitutes for these social reinforcers, by symbolising the approval or affection of others. cognitive reinforcers knowledge of results contributes to feelings of effectiveness and mastery (one aspect of self-esteem ), while perceptual novelty can cause the sort of intellectual exhilivation or interest felt when listening to music or poetry.

Behavioural results positive reinforcement strengthens the antecedent response. -people with tend to spend more time on and feel more enthusiasm for, enjoyable activities compared with less rewarding ones. many happy events involve readjustments and possible losses as well as pleasure e.g. marriage brings responsibilition and restrictions, as well as increased opportunities for sexual pleasure and attachment security. results stressful

Emotion and Health

The two broad areas in which emotion has been studied and presented in other basic sciences are; 1. the psychophysiology of emotion, and 2. psychological models of emotion, focusing on anxiety and depression, these aspects will be covered in psychiatry. Ruch and Zimbardo (1974) say, emotions can make you sick. They go on to say; when an organism faces a threat to its well-being, it may escape, avoid, or confront the dangerous situation. Sometimes when there is repeated intense arousal, the mind continues to function normally but makes unreasonably demands on the body. This results in psychosomatic disorders (psyche = mind and soma = body). This they say is brought on by psychogenic deterioration in bodily functioning. Psychosomatic disorders refer to symptoms involved in persistent emergency reaction, such as rapid pulse and high blood pressure, and to actual tissue damage that may result as in gastric ulcers. It is estimated that 1/3 1/2 of patients consulting physicians have symptoms originating largely from emotional disturbances. In fact some believe that illness and disease has some emotional base. Emotional factors are now clearly associated with ULCERS, HIGH BLOOD

PRESSURE, COLITIS, MIGRAINE, LOW BACK PAIN, DERMITITIS, OBERSITY, ASTHMA etc.

AFRICAN PERSPECTIVES ON EMOTION In Shona culture, like in the case of instincts, emotions are viewed to have a biological base. There are emotions associated with a persons inner positive development e.g. contentment, joy, happiness etc.; and those associated with inner turmoil and distructive tendencies e.g. rage, disgust, fear, anxiety etc. Emotions linked to inner positive growth are viewed as morally or spiritually correct. This is because a person with a positive attitude towards life and situations injects others with positive feelings even under difficult circumstances. Emotions associated with inner turnoil and destructive tendencies are regarded as negative and morally or spiritually incorrect. People associating with such persons are believed to also develop negative emotions. It is from this perspective that emotions are said to be contagious, kutapukira; or vadziya moto we mbavha i.e. guilty by association. It is also from this perspective that it is believed a mothers emotions can affect the development of her unborn baby. Emotions are associated with gender. It is accepted that women can publicly express joy, happiness etc., but men must not, even where the emotion is viewed as necessary. For example, the capacity to feel moved e.g. to tear is an experience people believe makes a person humble. Being moved to tears however, is viewed to be more appropriate for women and not men. Men are said to be emotionally stronger than women and are not expected to express their emotions through tears publicly. Men can express anger, rage, disgust etc. publicly but women are expected to exercise restrain. Empathy is a very important emotion for health care providers to develop for clinical work. EMPATHY is :putting yourself in another persons shoes. That is trying to understand another persons situation as if it were your own. Patients from local cultures often express dissatisfaction with state of the atr technical expertise of doctors and nurses if it is not accompanied with empathy. Many local people believe that encountering hostile reception during a visit with friends or at a health centre is a bad omen mashura. After such an encounter they often believe that the care and treatments they receive will not be proper or correct.

REFERENCE H. R. Winefield and M. Y. Peay (1980). Behavioural Science in Medicine London: George Allen and UNWIN and Beaconsfield Publishers.