Assist. Prof. T/Major P.

Gautam
M.Sc. Psychiatric Nursing
 Objectives
General objectives
• Describe the emotion and different changes
during emotional reaction.
• Explain different theories of emotion.
• State the purpose of emotion.
• Explain the effect of emotion on health.
• Illustrate the measures to control emotion
within self (as a nurse) and others (client).
 Specific Objectives
8.9 Emotion:-
• Definition/Introduction (review)
• Types of emotion (positive and negative emotion)
• External and internal changes that accompany emotional changes
(review)
• Measures to control emotion (review)
• Theories of emotion
– James-Lange Theory of Emotion
– Cannon-Bard Theory of Emotion
– Singer-Schachter Theory/Two Factor Theory of Emotion
– Cognitive-Appraisal Theory of Emotion
• Purpose of emotion
• Effect of emotion on health
• Measures to control emotion within self (as a nurse) and other (client)
 Introduction
• The word emotion Came from
the Latin word ''emovere''
which means ''to move out''.
• Simply, emotion is a feeling,
sentiment, reaction, passion,
excitement, or sensation.
• Emotion is a spontaneous
feeling arising from a person,
thing, or experience.
• It is subjective experiences.
Emotions are unique to each
individual, based on
perception.
 Conti…
• We feel excited when we pass our examination. We shout
when we get angry. We feel sorry at the death of our
loved one. We tremble when we are afraid.
• Anger, Happiness, Disgust, Surprise, Sadness, Fear,
Contempt are all emotions which influence our life and
behavior.
• We can not imagine without emotion a human being, they
add color in our life.
• Emotion considered as the building blocks of personality.
• Proper control and expression of emotions make living
pleasant, lack of control and improper expression leads to
mentally ill.
 Definitions
• “An emotion is a complex psychological state that involves
three distinct components: a subjective experience,
a physiological response, and a behavioral or expressive
response” (Hockenbury & Hockenbury, 2007).
• Emotions are subjective reactions to experiences that are
associated with physiological and behavioral changes
(According to Woolfolk).
• Emotions are feelings that generally have both
physiological and cognitive elements and that influence
behavior (Acc. to Feldman).
• Simply, It is Intense feeling that are directed at someone or
something.
 Classification of Emotion
• More than 200 emotions are named in the
English language. Psychologists have classified
them in many different ways:
• Basic Emotions
• Primary Emotion 
• Secondary Emotion
• Positive Emotion
• Negative Emotion
• Positive emotions: The pleasant emotions like
amusement, love, curiosity, joy and happiness which are
helpful and essential to the normal development.
• Negative emotions: The unpleasant emotions like fear,
anger, jealousy, which may harm to the well-being of an
individual. Negative emotions may destroy our energy,
and undermine our reputation. In negative emotional
state, we find lack of desire to do anything.
• Positive Emotions enhance self-esteem and improve our
relations with others while negative emotions lower self-
esteem and weakens the quality of our relations with others.
• But it should not be concluded that experiencing of positive
emotions are always good and that of negative emotions are
always bad.
• Negative emotions also may prove very essential for human
welfare. For example- a child who has no emotion of fear is
sure to get injured because he has not learnt to save himself
against a possible danger.
• Emotions with too much intensity and frequency, whether
positive or negative bring harmful effects.
• Emotions are essential in human life and it prepares an
individual to face the situation.
 Purpose of Emotions
Our emotions are composed of….
• a subjective component (how we experience the
emotion),
• a physiological component (how our bodies react to
the emotion), and
• an expressive component (how we behave in
response to the emotion).
• These different components can play a role in the
function and purpose of emotions.
1. Emotions can motivate us to take action.
2. Emotions help us survive, thrive, and avoid danger.
3. Emotions can help us make decisions.
4. Emotions allow other people to understand us.
5. Emotions allow us to understand others.
 FUNCTIONS OF EMOTIONS
• Three major functions of emotions by Feldman are:
1. Preparation for action - we are able to respond to changes
in our environment because our emotions enable us to
prepare to respond to the stimulus in our surroundings.
2. Shaping future behavior - constant exposure to stimuli
that stir our emotions enables us to learn, relearn and
unlearn a certain behavior.
3. Helping us interact more effectively with others - we are
interacting with one another almost every time.
understanding our emotions and emotions of others
enables us to sympathize/empathized with others.
 Changes During Emotions
• Changes during emotions are divided into external and internal changes.
1. External changes:
• There are many external or observable changes during emotion:
a. The voice and vocal expression changes according to the type of
emotion. Experiments have proved that emotions can be identified on
the basis of voice.
b. Facial expressions change. We can identify emotion by looking at
individual face.
c. Changes in the body postures like stiffness of muscles, twisting of
fingers, movements of hands and legs.
d. Sweating.
e. Wrinkles on forehead.
f. Redness of eyes.
g. Erection of hairs on the skin, etc.
Changes in facial expressions
Contempt
Disgust
Fear
Happiness
Sadness
Surprise
 2. Internal Changes
• Many internal changes take place during emotions.
These changes are the result of stimulation of the
Autonomic Nervous System. ANS has 2 subdivisions:
 Sympathetic division prepares the body for facing in
emergency situation either by fight or flight (fights if
possible, otherwise escapes from the situation).
• It stimulates the adrenal glands, that causes the excess
release of adrenaline and nor-adrenaline.
• Adrenaline gets circulated all over the body and
stimulates vital organs leading to following internal
changes:
a. Increase in heart rate thereby increase in BP.
b. Increase in rate of respiration.
c. Increase in the chemical composition of blood. E.g. blood
sugar level.
d. Decrease in functioning of GI tract-that is why we do not
experience the feeling of hunger during emotional states.
e. Changes in frequency of brain waves.
f. Dilatation of pupils
g. Decreased secretion of saliva result in dryness of mouth.

After the emergency, when the emotional situation is over

and next step starts to restore the energy during emotion.
This work is carried by parasympathetic division.
 COMPONENTS OF EMOTIONS
• Emotions have mainly three components: Cognitive,
Affective and (conative) Behavioral.
• Our cognitive appraisals evaluate the given situation,
prompting us to become emotional in one way or another, or
not at all.
• The affective (feelings) makes evident changes in an aroused
person. They rise many physiological processes in the body
system, stimulate nervous system and prompt widespread
electrochemical activities that leads to physical symptoms
such as increase in respiration and heart rate etc.
• The behavioral component is expressed in our facial,
postural, gestures and vocal responses.
 Theories of Emotion
• Theories of Emotions formulated by Different
Psychologists. Each theory emphasizes
different aspects of emotion, but no one
theory is comprehensive and adequate. A few
theories are discussed in brief here: 
 1. James-Lange Theory
• One of the first psychologists to attempt a scientific
explanation of emotion. The American psychologist William
James(1884) and Danish physiologist Carl Lange (1887)
proposed that emotions begin to appear from physiological
reactions.
• The perception of the stimulus causes our body to undergo
certain physiological changes and we experience emotion.
• For example, if I see a big scary dog barking at me, my heart
begins to race. Noticing my heart race, my brain figures out
that I am experiencing fear.
• This theory reversed the old common sense notion about the
sequence of the arousal of emotion (that is - see a bear, feel
afraid, run for safety).
 2. The Cannon-Bard Theory of Emotion
• In 1927 the American psychologist Walter B Cannon and L. L. Bard
proposed a new theory, on the basis of their findings by conducting
operations on various parts of brain, including Thalamus,
Hypothalamus and Cerebral cortex.
• Walter Cannon disagreed with the James-Lange theory of emotion
on several reasons.
• First, he suggested, people can experience physiological reactions,
without actually feeling those emotions. For example, our heart
might race because we have been exercising and not because we
are afraid.
• Second, emotional responses occur too quickly before physical
states. When we encounter a danger in the environment, we will
often feel afraid before we start to experience the physical
symptoms associated with emotion.
• According to the Cannon-Bard theory, emotion arousing
stimuli simultaneously triggered:
Physiological responses,
Subjective experience of emotion.
• We feel emotions and experience physiological reactions
simultaneously.
• It is suggested that emotions result when the thalamus
sends a message to the hypothalamus in response to a
stimulus, resulting in a physiological reaction. At the same
time, the thalamus also receives signals triggering the
emotional experience.
• Cannon and Bard’s theory suggests that the physical and
psychological experience of emotion happen at the same
time  but independently and that one does not cause the
other.
 3. Schachter-Singer Theory
• Many years later, two psychologists called Stanley
Schachter and Jerome Singer proposed another theory,
known as the Schachter-Singer Theory, Also known as the
two-factor theory of emotion. The Schachter-Singer
theory, suggests that experiencing an emotion requires
both bodily response and an interpretation of the bodily
response by considering the particular situation the person
is in at the moment (schachter & singer, 1962).
• This theory suggests that the physiological arousal occurs
first, then the individual identify the reason for this arousal
(cognitively interpreted the observable environmental
cues) to experience and label it as an emotion.
• Schachter and Singer’s theory draws on both the James-Lange
theory and the Cannon-Bard theory of emotion.
• Like the James-Lange theory, the Schachter-Singer theory
proposes that people do infer emotions based on physiological
responses. The critical factor is the situation and the cognitive
interpretation that people use to label that emotion.
• Like the Cannon-Bard theory, the Schachter-Singer theory also
suggests that similar physiological responses can produce varying
emotions.
• For example, If my heart is racing and a lion targeting me, I might
interpret that as fear. If my heart is racing and I am looking at the
person I am in love with, I might interpret that as excitement.
• Even though the bodily response is the same, I might experience
very different emotions depending on the type of situation I am
in.
• For example: imagine you are alone in a dark parking lot
walking toward your car. A strange man suddenly emerges
from a nearby row of trees and rapidly approaches. The
sequence that follows, according to the two-factor theory,
would be much like this:
1. I see a strange man walking toward me.
2. My heart is racing and I am trembling.
3. My rapid heart rate and trembling are caused by fear.
4. I am frightened!
• The process begins with the stimulus (the strange man),
which is followed by the physical arousal (rapid heartbeat and
trembling). Added to this is the cognitive label (associating the
physical reactions to fear), which is immediately followed by
the conscious experience of the emotion (fear).
James- Stimulus:
Physiological arousal
Emotion
trembling
Lange snake increased heart rate fear
theory

Physiological arousal
trembling
Cannon- Stimulus:
increased heart rate
bard snake
theory Emotion
fear

Physiological arousal
trembling
Two- increased heart rate
Emotion
factor Stimulus
fear
theory Cognitive interpretation
“I feel afraid!”
 4. LAZARUS THEORY
• Richard Lazarus developed the Lazarus theory of emotion. His
model “Cognitive Appraisal Theory of emotion” basically states
that a THOUGHT must occur before an emotion experience or
physiological response can take place.
• Any stimulus that causes emotional reaction, undergoes the
process of cognitive appraisal “mediatus” or ''to come
between'', which means that before the actual physical arousal
and emotional experience occurs, the person first interprets the
arousal.
• Stimulus - Appraisal (Mediate) - Emotional Experience -
Physiological Response.
• Therefore, a person sees a bear (event), the person thinks "I am
going to die" (thought), and the person simultaneously feels
fear and prepares for "fight or flight."  
 Effects of Emotion on Health
• Emotions are necessary for life. Emotions have a
stimulating effect. Emotions play a crucial role in
stimulate creative as well as artistic activities.
• Positive emotion can have positive impact on
health. Such as, love- it has a great healing
potential, this quality brings good health, Laughter-
Increase muscular and respiratory activity, increase
antibodies, body’s first line defense, decrease level
of stress, increase tolerance, Stimulates cardio
vascular system and stimulate nervous system.
• Ordinary physiological reactions during an emotion facilitate the
adjustment of the individual and these reactions do not last a long time
and not have any harmful effects on our body.
• But when an emotion recurs again and again and remains for a long
time, trouble may start, affecting the physical health.
• Harmful effect depends upon the intensity and duration of emotions.
When emotion becomes intense and for long either pleasant or
unpleasant, usually affect on disruption of thought or behavior, become
harmful.
• Intense and unpleasant emotions if persists for a long time, may cause
or worsen the condition of the person who is already ill.
• Persistent emotional disturbances caused by anger, fear and worries
have been found to be one of the causative factors in peptic ulcers,
heart disease, epilepsy and tuberculosis, made worse.
• Other illness in which emotion plays a vital role are bronchial asthma ,
high blood pressure, insomnia, chronic constipation etc.
• Modern medicine also shows that uncontrolled emotionality
plays a vital role in the causation of many physical disorders.
• Many physical complaints like peptic ulcer, colitis, skin diseases,
high or low blood pressure, asthma, migraine headache are
caused by reaction to emotional stress. They may also reduce
the effect of treatment for diseases.
• Sigmund Freud believed that mental illnesses came from
repressed emotions in the unconscious mind. If this emotional
energy was not released, it led to physiological symptoms and
illnesses. He termed these physiological manifestations of
emotions "psychosomatic." Freud believed that release and
acceptance of these denied or repressed emotions and
memories were vital for mental health.
• Hence, emotions are necessary for healthy life. But excess and
prolonged emotions are dangerous to health.
 Measures to Control Emotion
• However, emotions are inevitable in our life, we
cannot avoid them. As such emotions need not be
eliminated, but should be controlled to lead a
good life.
• This is what psychologists recommend today. Our
body functions well balanced when we are happy.
There is an old saying, ‘Joy is the best medicine’.
• So, as a nurse need to be concerned expression
and control of emotion within self (as a nurse) and
for clients.
 Within self (as a nurse):
• Try to understand within self- conflict, physical and emotional limits
• Learn as much as about physical reaction to emotional course.
• Greater knowledge helps to control over emotions.
• Plan work to avoid emergencies.
• Control stresses.
• Balance work with reactions, exercise and social activities.
• Practice relaxation by meditation, listening music, involving in hobbies
etc.
• Use sense of humor.
• Try to control unreasonable and excessive external expressions of
emotion.
• A desirable philosophy of life will enable us to avoid mental conflicts
and emotional tensions.
• The nurse should be emotional intelligence.
 Developing Emotionally Healthy Personality 
1. Exercise helps to restraint and moderation in the expression of
emotion.
2. Cultivate a sense of humor.
3. Learn to accept the inevitable things in life.
4. Develop an attitude of consideration and respect for the rights of
other people.
5. Pursue a hobby that will open new avenues of interest, attitude
and divert it from the routine work of daily life.
6. Be humble to accept own mistakes.
7. Avoid the occasions that will cause trigger violent emotions.
8. Redirect the expression of certain emotions through substitution
of more desirable ones—this is sublimation.
9. Learn to accept self for what we are.
10.Cultivate friendship.
 Other (For clients):
 Nurses spend maximum time with the clients therefore, the
nurse should assess the psychological reactions of the clients and
understand their emotional needs and plan for appropriate
nursing interventions.
• Understand the importance of verbal & non verbal emotional
reactions of the clients.
• Create welcome and ease atmosphere: welcome as an important
guest, hide self negative feelings towards the client, provide
pleasant & relaxed atmosphere.
• Understand client’s negative emotions: less self controllers,
tensed, irritable and unbalanced, and try to show patience,
maturity and make balance in behavior.
• Client’s negative emotions need to be substituted by positive
thoughts and emotions.
• Eliminate fear, anger, worry, anxiety and resentment by establishing
healthy interpersonal relationships.
• Promote positive feelings through understanding and accepting the client
as an individual.
• Develop empathy to release emotional expressions of the client so it helps
to overcome stresses.
• Understand client’s specific problems and try to solve appropriately, like
psychosomatic clients may need more time and attention, so nurse should
be patience.
• Provide therapeutic counseling according to the situation.
• Spend time with clients
• Listen while the client is describing his/her feelings
• Try to identify what is frightening to the client and offer appropriate
explanations
• Facilitate verbalization of feelings
• Handle the clients emotion, e.g. Verbalization of distress is often
accompanied by tearfulness.
• Show acceptance of the client’s behavior even if the
anger is directed at the nurse
• Try to determine the cause for anger and then deal
with it as realistically as possible
• Recognize that the client using denial protects himself
from something he does not wish to face
• Deal with denial carefully and in cooperation with
other health personnel
• Try to help the client find ways to cope with stress or
depression, such as engaging in some activities
• Show respect for the client’s feelings…..etc.

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