Talking about feelings

We doctors (perhaps, especially psychiatrists) are very ready to talk about ‘sick’ feelings - like depression and anxiety - but seem less comfortable in talking with our patients about anger, fear, sadness and shame. But these are common feelings in a medical setting.

Children are often prone to unregulated displays of affect, in particular angry outbursts or tantrums.  It is usual for others to respond to such angry behaviours in an antagonistic way.  Such antagonistic responses might represent a misreading of the angry communication.  Anger has two prominent evolutionary roles:-

•  An aggressive stand to make a claim for territory or for a mate to which the appropriate response is fight, submission or flight.
• a signal to a potential care giver that things are not right and require correction. 

No-one would think the angry cry of a hungry baby is a signal to leave the baby alone.  Too often angry or aggressive displays by children are treated as they belong to the first category rather than second. We fail to see that it is an emotional display aimed at engaging protective behaviours from potential caregivers.

Children are often clumsy in their expression and understanding of their own feelings.  It is not uncommon for a child who might be expected to be experiencing fear or sadness to behave in an apparently angry fashion.  The child himself may misperceive his own affective state.  It is our responsibility as adults to do a better job of reading the child’s affective state and recognising attachment based anger as a signal for increased comfort and reassurance rather than combat.