Abstract
Emotional maturity, the ability to take full responsibility for one's emotions rather than attributing them to external people or circumstances, is both a psychological milestone and a clinical necessity for emergency physicians. This article introduces the concept of emotional adulthood through a medical student case study and the APA's definition of emotional maturity, applying the cognitive thought model to demonstrate that emotions are created by thoughts about events, not the events themselves. The authors argue that physicians who operate from emotional adulthood, recognizing that no one can make them feel anything they do not choose, gain freedom, effectiveness, and resilience that directly improves clinical presence, collegial relationships, and personal well-being. Ten characteristics of emotionally mature people are presented, applied to the ED context, with practical reframing strategies for common emotional triggers in emergency medicine.
Key Findings:
- ● Emotional maturity, defined by the APA as "a high and appropriate level of emotional control and expression", is achieved by relatively few people, as most adults continue to operate from patterns of emotional childhood in which external events and other people are held responsible for their feelings.
- ● Emotions are not caused by events or other people's behavior, they are generated by thoughts about those events; the same interaction can produce entirely different emotional responses depending on which thought a person chooses to have about it.
- ● Physicians who recognize this, that no one can make them feel anything they don't choose to feel, gain full emotional agency: the power to decide how much weight to give a rude consultant, an ungrateful patient, or a difficult shift without being destabilized by any of them.
- ● Emotional childhood manifests in medicine as instrument-throwing, chart-slamming, emotional outbursts, and post-shift numbing behaviors, all driven by the unconscious belief that external circumstances control internal states.
- ● Ironically, many characteristics of emotional maturity, flexibility, comfort with uncertainty, humor, seeking multiple perspectives, are already displayed by emergency physicians clinically; the challenge is transferring them to interpersonal and personal emotional responses.
Ten traits of emotional maturity applied to emergency medicine
- 🔄 Flexibility
EPs working variable shifts across specialties are already among the most flexible professionals on the planet.
- 📚 Seeking learning opportunities
"I wonder how she gets charts done so much faster?", curiosity over competition.
- 🤔 Knowing they don't know everything
UpToDate, EM:RAP, and four-consultant mystery workups, comfort with uncertainty is an EP specialty.
- 🔭 Multiple points of view
Seeking broad input on complex cases is already standard EP practice, apply it interpersonally too.
- 🧊 Remaining calm under pressure
No cooler cucumbers on the planet than emergency physicians in a resuscitation bay.
- 😄 Good sense of humor
A survival skill unique to those who have worked a Friday night in a busy ED and emerged intact.
Reframing common EP emotional triggers from childhood to adulthood
RUDE OR CONDESCENDING CONSULTANT
"His behavior is 100% about him, not me. I'm glad I don't have to live with that guy, and I will always do what I think is right for my patients."
MAKING AN ANATOMICAL ERROR OR KNOWLEDGE GAP
"Dang, I misspoke. I won't mix those up again.", and carry on. The mild embarrassment passes; the raging response does not.
PATIENT OR FAMILY WHO IS DIFFICULT OR UNGRATEFUL
"Their behavior is about where they are, not who I am. I can give good care regardless of how it's received."
SYSTEMIC FRUSTRATIONS (BOARDING, STAFFING, METRICS)
"I don't want to give the power of whether I have a good shift to a person or system like that. See next patient."
"We will know we have arrived at full emotional maturity when we accept complete responsibility for our emotions, no one can make us feel anything we don't choose to feel. Operating in real adulthood offers us the freedom and power to know that we get to choose and create whatever we want in our lives."
Publication details:
JOURNAL
Emergency Medicine News
VOLUME / ISSUE
Vol. 44, No. 10, p. 14
PUBLISHED
October 2022
AUTHORS
Laura Cazier, MD; Amanda Dinsmore, MD; Kendra Morrison, DO
DOI
10.1097/01.EEM.0000891132.54516.e2
PUBLISHER
Wolters Kluwer Health / LWW
