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Consequences of Repression of Emotion: Physical Health, Mental Health and General Well Being



The widely held belief that emotional and psychological processes affect our physical health, mental health and general well-being are central to a holistic view of the individual, and as such, it is a useful foundational concept in integrative medicine. The purpose of this paper is to review substantial amounts of the latest research and recent findings on this issue to enable us to throw some light on how inhibitory factors to emotional expression and experience can endanger our health, both physically and psychologically including our general wellbeing. In addition, the connection between repression of emotion and certain mental disorders like depression and scientifically proven healthy ways to manage issues bordering on emotion was outlined. The information contained in this paper is just as important to health care providers and also to the patients they deal with
Freely Available Online | IJPR CC-license DOI : 10.14302/issn.2574-612X.ijpr-18-2564 Vol-1 Issue 3 Pg. no.- 16
Consequences of Repression of Emotion: Physical Health, Mental Health and General Well Being
Jainish Patel1, Prittesh Patel2,*
1Indira Gandhi National Open University, Regional Center, Surat
2C. G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Bardoli
The widely held belief that emotional and psychological processes affect our physical health, mental
health and general well-being are central to a holistic view of the individual, and as such, it is a useful
foundational concept in integrative medicine. The purpose of this paper is to review substantial amounts of the
latest research and recent findings on this issue to enable us to throw some light on how inhibitory factors to
emotional expression and experience can endanger our health, both physically and psychologically including our
general well being. In addition, the connection between repression of emotion and certain mental disorders like
depression and scientifically proven healthy ways to manage issues bordering on emotion was outlined. The
information contained in this paper is just as important to health care providers and also to the patients they
deal with.
DOI : 10.14302/issn.2574-612X.ijpr-18-2564
Corresponding author: Prittesh Patel, Assistant Professor, C. G. Bhakta Institute of Biotechnology, Uka
Tarsadia University, Bardoli, Maliba Campus, Surat, Gujarat, India, Tel: +91 9913668812;
Key words: Emotion, Psychology, Depression, Patients, Mental Health, Repression
Received: Dec 22, 2018 Accepted: Feb 09, 2019 Published: Feb 12, 2019
Editor: Wei Xu, School of Psychology, Nanjing Normal University, China.
ISSN NO: 2576-612X
Freely Available Online | IJPR CC-license DOI : 10.14302/issn.2574-612X.ijpr-18-2564 Vol-1 Issue 3 Pg. no.- 17
In psychology, repression of emotion is an
aspect of emotion regulation. It is a concept that is
based on individuals knowledge of emotions, which
includes causes of emotion, sensations of the body and
about behavior that are expressed, and their possible
means of modification [1]. Repression of emotion
implies the act of masking facial and bodily expressions
in order to conceal a current emotional status.
Repression of emotion can also be defined as the
intentional and automatic method by which individuals
exert control over the emotions they have, altering
factors like when and how the emotions are experienced
and expressed [2]. Effective regulation of emotion
enables the individual to adaptively cope with a broad
range of environmental eventualities. However, when it
goes uneven or lopsided, it becomes increasingly
recognized and its negative consequences may pose
danger to emotional and cognitive health. It may thus
become a potential development or maintenance factor
in mental or physical disease conditions [3-5]. Toxic
affect is talking about the novel idea that negative
emotional conditions can have consequences for the
physical health of an individual. Reviews from available
research indicate that both anxiety disorders and
depressive symptoms are implicated as risk factors for
people with cardiac abnormalities [6].
It becomes important to understand the positive
and negative consequences of different emotion
regulation strategies. In this respect, controversy is
ongoing in the field about the repercussions of
deliberate attempts to repress emotion, defined here as
intentional attempts to down-regulate the inward
experience and outward expression of undesired effect.
Contradictory predictions arise from normative and
clinical works of literature concerning the consequences
of such repression of emotion.
Clinical and Normative Findings
People repeatedly and rapidly forget and
re-discover that emotional status has a direct and
profound influence on physical and mental health [7].
Freud discovered links between repression of emotion
and physical symptoms nearly a century ago. Wolff and
his colleagues also documented fixed physiological
responses to emotional activation in more than three
decades worth of research [8]. More recently, research
findings have been adding up in support of the notion
that the relationship between emotional and physical
health is direct and reciprocal. Research has shown that
over 80% of all physiciansvisits have to do with a
socio-emotional challenge, while just only 16% could be
considered solely pathophysiologic in nature. One study
discovered that 84 % of 567 common complaints, such
as dizziness and chest pain, indicated no medical
diagnosis [9]. A recent study out of the UK discovered
that about 25% of all new specialty referrals and about
20% of all referrals requiring surgery resulted in no
particular medical diagnoses [10]. It becomes imperative
and clear that a more keen understanding of the roles of
emotions in the occurrence and progression of
symptomatic suffering is necessary in order to curtail the
staggering amount of medical costs spent involved in
diagnosing these symptoms that are borne out of
emotional imbalance. Abbass (2002) further made this
very clear by documenting the enormous cost savings to
the system when such cases are given brief emotionally
focused psychotherapy [11]. Learning and
understanding how and when such therapies come into
the treatment plan of medical systems will be a great
service to all and sundry.
Management of Emotions
The ways in which humans manage their
emotions has become one of the most important but
least examined concerns in medicine today. Emotions
are physiological phenomena [12]. When poorly
managed or regulated, they can lead to negative health
and psychological consequences [13].
One important factor that links emotions and
health disorders has to do with the (dys) regulation of
emotions [14]. Patients with difficulties in managing
their emotions subject their health and well being into
gross negligence and as a result are more likely to
display a history of substance abuse, poor nutrition, and
disordered eating, lack of exercise, abnormal sleep
patterns, poor compliance with medical interventions
and behaviors that are injurious to one self. These
patients make use of medical services like emergency
rooms and medications, at tremendous rates. Because
they often fail to stick to the directives of medical advice
and treatment prescriptions, such patient s create
Freely Available Online | IJPR CC-license DOI : 10.14302/issn.2574-612X.ijpr-18-2564 Vol-1 Issue 3 Pg. no.- 18
conflicts with health workers and are more likely to file
complaints in the court than patients that are
emotionally healthy and stable [15].
It is important to acknowledge that feelings and
emotions are not responsible for health disorders and
sicknesses. Rather it is the protracted reliance on
self-defense against the expression of emotions and
feelings that creates the tension required for the disease
to thrive [16]. Conversely, the free and uninterrupted
expression of emotion possesses clear and sustainable
benefits for physical and mental health and general well
being. In fact, research on aging and longevity has
demonstrated that psychological factors bordering on
emotions are more important predictors of a long,
healthy life than other factors like diet and
activeness [17]. Individuals who remain actively involved
in issues of life has a sense of hope and sheer optimism
and can deal with moments of sadness by finding
purpose and meaning, instead of bowing to depressed
and despondency. They are also more likely to live
longer and healthier than their pessimistic counterparts.
Physiological Consequences of Repression
Studies by Pennebaker and his colleagues
(1997) demonstrated that individuals who repress their
emotions also suppress their bodys immunity, making
them more vulnerable to a variety of illnesses ranging
from common colds to cancer [5]. Again, individuals
who mask and deny their inward feelings, or outwardly
vent their emotions, characteristically suffer most.
Studies of patients with serious medical conditions such
as cancer, diabetes, kidney failure, and obesity, reveals
that those who do not comply with medical advice also
show strong use of defense mechanisms” [5]. Other
findings have demonstrated that patient with cancer and
other forms of malignancy that chronically mask their
experiences and feelings are more liable to die despite
treatments than expressive patients [18, 19]. Empirical
evidence indicates a substantial reduction in pain and
discomfort from arthritis following the expression of
negative. As a matter of fact, the amount of relief from
pain and discomfort reported by patients with chronic
illness has been found to be commensurate with how
able they are too deeply and authentically express their
emotions and feelings. The table 1 shows some of the
physiological manifestations repression of emotion
health workers are likely to come across.
Psychological Consequences of Repression
Repression of emotion is one of the most
common strategies of regulating emotion used by
humans. Clinical traditions made it clear that the
psychological health of an individual depends on how
effective impulses are managed or regulated; the
Table 1. Emotionally linked complaints and disorders (Abbass, 2005)
Specialty Complaint/Disorder
Cardiology Hypertension, Chest Pain, Palpitations
Dermatology Psoriasis, Dermatitis, Itching
Endocrinology Fatigue, Obesity, Thyroid Dysfunction
Gastroenterology Irritable Bowel Syndrome, Dyspepsia, Abdominal Pain
Internal Medicine Weakness, Pain, Fatigue
Neurology Conversion, Paralysis, Headache, Dizziness, Pseudo-
Gynecology Pelvic Pain, Sexual Dysfunction, Infertility
Ophthalmology Visual Blurring, Tunnel Vision, Blindness
Respirology Shortness Of Breath, Choking Spells, Chest Pain
Rheumatology Fibromyalgia, Fatigue, Chronic Pain
Surgery Back Pain, Neck Pain, Abdominal Pain
Urology Urethral Syndrome, Sexual Dysfunction
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consequences of effective regulation and management
are, therefore, the main focus of researchers in clinical
psychology. Gross & Levenson (1993) explained how
the psychological consequences directly related to
repression of emotion are subjects of frequent dispute
among researchers [4]. Researchers such as Cannon
(1927) and Jones (1935) are of the opinion that
suppressing a physical emotional response while
emotionally prompted to express will increase the
intensity of the emotional experience as a result of the
concentration on suppressing the emotion [20, 21].
These researchers debate that common sense makes us
understand that emotions become increasingly severe
or intense the longer they are bottled up. Some other
researchers such as Darwin (1872) and Tomkins (1984)
express their disagreement with this theory with the
view that emotional expression is crucial to the overall
emotional response and that when there is repression,
all other contingent responses (e.g. physiological) are
weakened [22, 23]. Darwin (1872) and Tomkins (1984)
threw more light on this argument by stating the
obvious that people are taught to count numbers to ten
when emotionally distressed in order to calm
down [22, 23]. If repression of emotions were to
increase the intensity of the expressible emotional
experience, this counting tradition would only increase
the response of the person emotionally aroused;
however, the reverse is actually the case [22, 23].
Unfortunately, few pieces of research have been
conducted to test these hypotheses [24]. The fact that
people have contrasting opinions on which is the
idea- to repress emotion by counting numerals to ten to
calm down before acting or expressing the way you feel
because repressing your emotions is injurious to your
mental health is of increasing interest and concerns to
experts in the psychology of emotions.
The Connection with Stress
The various physiological, cognitive, and
motivational, and physiological attributes of emotions
may shed some light on their relation with hypertension
as one of the risk factors of cardiac malfunction.
Previous studies has indicated that stress is linked with
increased cortisol levels, This has gained support from
other research findings showing that how the body
responds during stress depend on how one is able to
deal with the stress [25]. Concealing and repressing
emotions can give rise to stress-related physiological
reactions. The occurrence of stress is as a result of the
social disapproval and punishment of overt emotional
expression that cause repression which is itself
intimidating and stressful [26]. There are certain fields
of human endeavor which require the repression of
positive or negative emotions such as: estate agents
who may hide their happiness when a good offer is
tabled on house sake of maintaining their
professionalism, or primary school teachers suppressing
their anger or disappointment sake of upsetting their
young pupils when teaching them good morals.
Recently, researchers have started to look into
the effects which continual repression of emotion in the
workplace may have on people [27]. Cote (2005) stated
that continual repression brings about stress on
individuals making use of it [27]. Stress brought about
by such protracted repression of emotion can cause an
increase in heart rate, anxiety, low level of commitment
and other effects which can be detrimental to the
productivity of an employee. The popular belief is that
repression of emotion in the workplace is advantageous
for the organization and dangerous for the employee on
a long-term basis. However, Cote (2005) discovered
that factors giving rise to the social dynamics of
emotions determine whether regulation of emotion
affects stress or not [27]. The repression of unpleasant
emotions such as anger gives rise to elevated levels of
Repression and Depression: The Link
Repression of emotion, as a strategy to regulate
emotions, is useful in certain aspects of life such as
supporting ambitions pursuits and bringing satisfaction
to hedonic needs [28]. In as much as repression of
emotion is regarded as a weak influence on emotional
experience, it plays other useful roles. Repression of
emotion is a goal-oriented strategy which is guided by
peoples beliefs and customs and potentially by abstract
ideas about the regulation of emotion [28]. In a
research conducted by Larsen et al. (2012) the
researchers investigated the possibility of a positive
association between repression of emotion and
symptoms of depression in adults and adolescents
under the influence of peer victimization and parental
Freely Available Online | IJPR CC-license DOI : 10.14302/issn.2574-612X.ijpr-18-2564 Vol-1 Issue 3 Pg. no.- 20
support [28]. A reciprocal relationship was discovered to
exist between parental support and symptoms of
depression but there was no symptom of depression
with peer victimization. Depressive symptoms were
discovered in the subjects following decreased
perception of parental support after a year.
Recommendations and Conclusion
In conclusion, it is clear that expressing ones
true emotions and the feeling is crucial to physical
health, mental health, and general well being, while a
reliance on concealment gives rise to a barrier to good
health. In as much as having a family member or a
trusted friend to confide in seems like the best option, it
is not the only one. Talking with a psychotherapist or a
counselor is another method of getting help.
Alternatively, one may resort to writing down ones true
feelings and emotions, or simply recording with tape the
particular events in one's life that have been most
upsetting and emotionally distressing. These practices
have been found to have beneficial effects in managing
and regulating emotions. Facing what one has been
trying to avoid can elevate one's sense of distress or
emotional arousal in the short term, the benefits are far
much greater as one gains emotional stability, physical
and mental health, and also a wider understanding of
oneself and others. Most importantly, the long-term
benefits are only for people who are willing to get
involved in this process emotionally. Having someone to
talk to about your feelings in a state of detachment will
not help one achieve much in becoming emotionally
stable, talking to an expert will do more.
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The art and science of yoga is dedicated to creating union between body, mind and soul. Its objective is to assist the practitioner in using the breath and body to foster an awareness of ourselves as individualized beings intimately connected to the unified whole of creation. In short it is about creating balance and equanimity so as to live in peace, good health and harmony with the greater whole. This art of right living was perfected and practiced in India thousands of years ago and the foundations of yoga philosophy were written down in the Yoga Sutra of Patanjali, approximately 200 AD. This sacred text describes the inner workings of the mind and provides a blueprint for controlling its restlessness so as to enjoy lasting peace. Yoga is now practiced by millions across the globe. This is great for humanity, however a lot of yoga that is being practiced today is merely just asana & some amounts of pranayama. Even asana has been diluted to a mere form of exercise and often teamed with other things (like heat, chocolate, music, weights etc...) that are completely external to classical yoga. Very few practitioners go beyond asana.
Historically and contemporarily, Black Americans have been compelled to use effortful coping styles characterized by high behavioral and emotional restraint in the face of systematic racism. Lynch and colleagues have previously conceptualized a class of regulatory strategies—overcontrolled coping—characterized by emotional suppression, hypervigilance for threat, and high distress tolerance, which bear close analogy to coping styles frequently used among individuals facing chronic racial stress. However, given the inherent culture of racism in the United States, engaging in highly controlled coping strategies is often necessitated and adaptive, at least in the short term. Thus, for Black Americans this class of coping strategies is conceptualized as culturally compelled coping rather than overcontrolled coping. In the current article, I offer a critical examination of the literature and introduce a novel theoretical model—culturally compelled coping—that culturally translates selected components of Lynch’s model. Cultural translation refers to considering how the meaning, function, and consequences of using overcontrolled coping strategies changes when considering how Black Americans exist and cope within a culture of systematic racism. Importantly, this model may offer broad implications for future research and treatment by contextualizing emotion regulation as a central mechanism, partially answering how racism “gets under the skin” and affects the health of Black Americans.
Aims and objectives: This study explored how Registered Nurses (RNs) in rural practice deal with psychologically traumatic events when living and working in the same rural community over time. Background: Rural RNs who are exposed to trauma may be at high risk for psychological distress (e.g. secondary traumatic stress, vicarious trauma and post-traumatic stress disorder), in the context of isolated practice and slower emergency response times. Design and methods: Charmaz's constructivist grounded theory methodology was chosen for this qualitative study. Purposeful sampling was used to recruit 19 RNs from six rural acute care hospitals. A total of 33 interviews were conducted with 19 face-to-face initial interviews, 14 follow-up telephone interviews and 14 reflective journals. Adherence to the COREQ EQUATOR guidelines was maintained. Results: Participants were exposed to a multitude of trauma-related events, with their main concern of being intertwined with events for life. They dealt with this by staying strong, which included relying upon others, seeking inner strength, attempting to leave the past behind and experiencing transformational change over time. Being embedded in the community left them linked with these trauma-related events for life. Staying strong was a crucial element to their ability to cope and to face future events. Conclusions: The psychological implications of trauma-related events when working and living in rural acute care practice settings are significant and complex. Findings highlight the need for organizational support and processes and may contribute to improved psychological services and management practices. Relevance to clinical practice: Key learnings were that rural nurses, who live and work in the same community, experience psychological changes over time from traumatic events that stay with them for life; employers fail to recognise the seriousness of this issue and trauma-informed policies with associated resources are lacking.
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Regulating affective responses to acute stress has the potential to improve health, performance, and well-being outcomes. Using the biopsychosocial (BPS) model of challenge and threat as an organizing framework, we review how appraisals inform affective responses and highlight research that demonstrates how appraisals can be used as regulatory tools. Arousal reappraisal, specifically, instructs individuals on the adaptive benefits of stress arousal so that arousal is conceptualized as a coping resource. By reframing the meaning of signs of arousal that accompany stress (e.g., racing heart), it is possible to break the link between stressful situations, and malignant physiological responses and experiences of negative affect. Applications of arousal reappraisal for academic contexts and clinical science, and directions for future research are discussed.
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5 Emotion-linked disorders are common and costly, but diagnosable and treatable. These disorders can lead to excessive medical service use, poor outcomes and disability. When physicians have emotion-linked disorders, medical error can occur. With the advent of new diagnostic techniques and brief psychotherapies, medical educators are now able to teach residents how to better understand, diagnose and manage the emotional components of medical care.
Handwritten autobiographies from 180 Catholic nuns, composed when participants were a mean age of 22 years, were scored for emotional content and related to survival during ages 75 to 95. A strong inverse association was found between positive emotional content in these writings and risk of mortality in late life (p < .001). As the quartile ranking of positive emotion in early life increased, there was a stepwise decrease in risk of mortality resulting in a 2.5-fold difference between the lowest and highest quartiles. Positive emotional content in early-life autobiographies was strongly associated with longevity 6 decades later. Underlying mechanisms of balanced emotional states are discussed.
Although the concept of the defense mechanism was rejected from academic psychology for a number of years, recent empirical studies show renewed interest in defenses. Cognitive psychologists have confirmed the existence of unconscious psychological processes, a requisite for defenses. Developmental, personality, and social psychologists have all found evidence for defense mechanisms that explicate psychological functioning. The relevance of this new information for clinical practice is discussed.
Current models of how emotion regulation impacts strain focus on intraindividual processes that operate within the mind and body of the person regulating the emotion. This article presents a social interaction model of how emotion regulation impacts strain based on interpersonal processes. In this model, explanations of how emotion regulation impacts strain are based on the receiver's response to the sender's emotion regulation and display, the form of emotion regulation, and the emotion being regulated.
Recent investigations have shown increased disease progression among breast cancer patients with a “repressive” coping style characterized as: passive, conforming, inclined to deny physical symptoms and emotionally unexpressive. The Millon Behavioral Health Inventory (MBHI) scales which delineate three discrete repressive coping styles include the: Introversive, Cooperative and Respectful. Forty-four women recently diagnosed (within four weeks) with non-metastatic (N=32) or metastatic (N=12) breast carcinoma, responded to the MBHI upon admission for treatment of their disease at a cancer treatment unit. All subjects received mastectomy as well as chemotherapy, radiation and/or endocrine therapy. These 44 Cancer patients were compared to 34 control subjects, comprising women who were seen at a colposcopy clinic for follow-up of a suspicious pap smear which was ultimately shown to be benign or consisted of mild dysplasia. Non-metastatic, metastatic and control subjects were compared with respect to coping style and psychological distress. The breast cancer patients were more likely to employ a repressive coping style as compared to non-cancer patients who utilized a “sensitizing” coping strategy predominantly. Cancer patients with the most severe prognosis (metastasis) were the only group within the study to attain a clinically significant mean base rate score on the respectful scale. Results suggest that the incidence of repressive coping styles may be disproportionately high among breast cancer patients.
Anyone who has ever entrusted a troubling secret to a journal, or mourned a broken heart with a friend, knows the feeling of relief that expressing painful emotions can bring. This book presents evidence that personal self-disclosure is not only good for our emotional health, but boosts our physical health as well. The author has conducted controlled clinical research that sheds light on the mind–body connection. This book interweaves his findings with case studies on secret-keeping, confession, and the hidden price of silence. "Opening Up" explains: How writing about your problems can improve your health; How long-buried trauma affects the immune system; Why it's never too late to heal old emotional wounds; and When self-disclosure may be risky—and how to know whom to trust. (PsycINFO Database Record (c) 2012 APA, all rights reserved)