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INTRODUCTION

Clinical encounters are often emotional events—few situations are more emotionally laden than when a person’s health is at stake. But the role of emotion goes beyond patients’ emotional experiences and expressions; it also includes the ways in which people respond to and manage the emotions they experience. It is clear that how people regulate their emotions plays an important role in both physical and mental health outcomes.1–4 Our goal in this chapter is to expose providers and trainees to the most relevant concepts and current thinking about emotion regulation for patient care and the patient–provider relationship, and to encourage awareness of these issues during the clinical encounter. Clinicians’ understanding of emotion regulation offers opportunities to improve experiences of both patients and providers in clinical care interaction, and for dynamic interpersonal effects within the patient–provider relationship that improve intervention and treatment outcomes.

This chapter integrates research findings from psychological science to introduce definitions and basic concepts in emotion regulation, describe specific emotion regulation strategies likely to appear in patient care, and address the social and interpersonal contexts of emotion regulation and their relevance to the clinical encounter. It concludes with a discussion of recommendations and challenges for application in clinical care, including assessment and intervention, and a discussion of providers’ own emotion regulation and its role in provider and patient outcomes. Throughout the chapter we provide brief case examples illustrating the role of emotion regulation across the range of health professions. Some are fictional cases and some are drawn from our experiences as clinical psychologists, with identifying details changed.

WHAT IS EMOTION REGULATION? DEFINITIONS AND BASIC CONCEPTS

James Gross, a prominent scholar in modern emotion regulation research, has summarized the construct as “the processes by which we influence which emotions we have, when we have them, and how we experience and express them.”5,6 Others have defined emotion regulation as including processes involved in monitoring, evaluating, and making sense of emotional reactions before they can be regulated.7,8 What all definitions of emotion regulation have in common is a focus on the processes by which individuals modulate their own emotional states. Underlying emotion regulation is an intricate set of biological, psychological, and social mechanisms that allow individuals some degree of influence—sometimes intentional and sometimes relatively automatic—over their emotions. This section introduces several key concepts fundamental to understanding the nature and applications of emotion regulation.

Emotion Regulation versus Coping

To grasp the concept of emotion regulation, it is useful to distinguish it from its close relative, coping. The concept of coping was developed before the concept of emotion regulation, and it has a long history in psychology and health care.9,10 Generally speaking, much of coping is problem-focused; it describes how people respond to the demands of stressors themselves, such as generating, evaluating, and implementing solutions to problems. Other coping efforts are more ...

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